In this study, we have demonstrated that the risk of transaminitis in patients with RA taking MTX does increase with increasing levels of alcohol consumption. However, the risk in those patients who consume ≤14 units of alcohol per week is no greater than those who do not drink alcohol. This is the first study to provide quantifiable estimates of the risk of different levels of alcohol consumption while taking MTX, in a large group of patients who take long-term MTX. The study has important clinical implications. At present, there is uncertainty about the acceptable levels of alcohol consumption while taking MTX, and different rheumatologists and healthcare practitioners may give different advice on what is safe. This can lead to patients avoiding MTX altogether in favour of modest (and perhaps safe) alcohol consumption and thus missing its potential benefits; avoiding any alcohol and potentially affecting their quality of life; or worrying about the potential consequences of any alcohol they consume.
Jenny H Humphreys, Alexander Warner, Ruth Costello, Mark Lunt, Suzanne M M Verstappen, and William G Dixon, “Quantifying the Hepatotoxic Risk of Alcohol Consumption in Patients with Rheumatoid Arthritis Taking Methotrexate”, Annals of the Rheumatic Diseases (2017), 3. {Available online at http://ard.bmj.com/content/annrheumdis/early/2017/03/23/annrheumdis-2016-210629.full.pdf}