When used with disease-modifying antirheumatic drugs (DMARDs), long-term methotrexate therapy appears to cause liver abnormalities in patients with juvenile idiopathic arthritis (JIA), according to a recent report. However, these abnormalities are mild and seem to resolve when methotrexate is discontinued.
Liver fibrosis and cirrhosis have been reported in adult arthritis patients treated with methotrexate therapy. In contrast, no serious adverse hepatic effects have been observed with low-dose methotrexate therapy in children. Still, it is unclear if the current trend of using higher doses of methotrexate in combination with DMARDs might have severe hepatotoxic effects in children.
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