When treating rheumatoid arthritis with methotrexate, which laboratory test should be monitored?

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Multiple Choice

When treating rheumatoid arthritis with methotrexate, which laboratory test should be monitored?

Methotrexate in rheumatoid arthritis can cause liver injury, so the most important laboratory to monitor is liver function tests. Regular checks of AST and ALT (often with alkaline phosphatase and bilirubin) before starting therapy and at intervals during treatment help detect hepatotoxicity early, allowing dose adjustments or discontinuation if needed. Baseline liver tests are essential, followed by periodic monitoring especially in the first months or if risk factors exist (alcohol use, obesity, diabetes, liver disease). Lipid panels, calcium, and magnesium aren’t specific indicators of methotrexate toxicity and aren’t used to guide MTX dosing or safety in this context.

Methotrexate in rheumatoid arthritis can cause liver injury, so the most important laboratory to monitor is liver function tests. Regular checks of AST and ALT (often with alkaline phosphatase and bilirubin) before starting therapy and at intervals during treatment help detect hepatotoxicity early, allowing dose adjustments or discontinuation if needed. Baseline liver tests are essential, followed by periodic monitoring especially in the first months or if risk factors exist (alcohol use, obesity, diabetes, liver disease).

Lipid panels, calcium, and magnesium aren’t specific indicators of methotrexate toxicity and aren’t used to guide MTX dosing or safety in this context.

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