Treatment of methotrexate in rheumatoid arthritis: In-depth understanding of hepatotoxicity and its molecular mechanisms

At lower doses, Methotrexate plays an anti-inflammatory role in RA mainly by regulating adenosine signaling pathways and is a cornerstone drug in RA treatment. However, the potential hepatotoxicity of MTX poses a challenge to clinical treatment , especially in the elderly RA patient population, where long-term treatment and multiple medications aggravate the risk of hepatotoxicity.

In vivo studies show that: Pathological processes such as inflammation, oxidative stress and lipid peroxidation may be involved in MTX-induced liver injury. However, the exact molecular mechanism of MTX-induced liver injury remains unclear. Therefore, this paper will review the research progress of MTX-induced liver injury in RA treatment, including clinical features, risk factors and possible molecular mechanisms.