Which test is most appropriate to monitor methotrexate therapy for potential liver toxicity?

Which test is most appropriate to monitor methotrexate therapy for potential liver toxicity?

• A. Liver function tests
• B. Renal function tests
• C. Blood glucose
• D. Thyroid function

Answer: (A)

Methotrexate can cause liver toxicity, so regular monitoring with liver function tests is essential to detect injury early. These tests assess hepatocellular injury and biliary function by measuring enzymes and substances such as ALT and AST (indicators of liver cell damage), alkaline phosphatase and GGT (bile flow/cholestasis), and bilirubin (overall liver excretory function). A baseline panel is done before starting therapy, followed by periodic testing during treatment, with frequency depending on dose, treatment duration, and individual risk factors. If transaminases rise or bilirubin increases, clinicians may adjust the dose or pause therapy to prevent progression. Renal function tests evaluate kidney function and MTX clearance but do not specifically monitor for liver toxicity. Blood glucose and thyroid function assess other systems and aren’t used to monitor hepatotoxicity from methotrexate.

Methotrexate can cause liver toxicity, so regular monitoring with liver function tests is essential to detect injury early. These tests assess hepatocellular injury and biliary function by measuring enzymes and substances such as ALT and AST (indicators of liver cell damage), alkaline phosphatase and GGT (bile flow/cholestasis), and bilirubin (overall liver excretory function). A baseline panel is done before starting therapy, followed by periodic testing during treatment, with frequency depending on dose, treatment duration, and individual risk factors. If transaminases rise or bilirubin increases, clinicians may adjust the dose or pause therapy to prevent progression.

Renal function tests evaluate kidney function and MTX clearance but do not specifically monitor for liver toxicity. Blood glucose and thyroid function assess other systems and aren’t used to monitor hepatotoxicity from methotrexate.