West identified factors associated with an increased risk for hepatotoxicity in a patient receiving methotrexate therapy.
duration of therapy > 2 years; cumulative dose > 1,500 mg
maximum weekly dose > 25 mg
obesity and diabetes mellitus
obesity or diabetes mellitus alone
concurrent liver disease
pre-existing liver disease; previous or concurrent heavy ethanol use
heterozygous alpha-1 antitrypsin deficiency; Felty's syndrome
Therapies increasing risk:
(1) concurrent NSAID use (potential)
(2) concurrent cyclosporine (potential)
(3) concurrent PUVA therapy (potential)
(4) previous therapy with vitamin A (potential)
(5) previous therapy with arsenicals (probable)
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Purpose: To evaluate a patient taking methotrexate for risk factors associated with hepatoxicity.
Specialty: Gastroenterology, Immunology/Rheumatology, Pharmacology, clinical
Objective: risk factors, complications