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Combining methotrexate and leflunomide for treating rheumatoid arthritis can lead to elevated liver enzymes. In a study, about 20% of participants experienced two to three-fold increases in transaminases, and higher elevations occurred in 7% (AST) and 17% (ALT) of patients. Persistent enzyme elevation led to the withdrawal Show Full Answer

Combining methotrexate and leflunomide for treating rheumatoid arthritis can lead to elevated liver enzymes. In a study, about 20% of participants experienced two to three-fold increases in transaminases, and higher elevations occurred in 7% (AST) and 17% (ALT) of patients. Persistent enzyme elevation led to the withdrawal of three subjects from the study. However, liver biopsies in subjects with persistent enzyme elevations showed no evidence of marked fibrosis or cirrhosis, indicating that while liver enzyme elevations are a concern, significant liver damage was not observed in these cases. It's important for patients on this combination therapy to have their liver enzymes monitored regularly.

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Combining Methotrexate and Leflunomide for the treatment of Rheumatoid Arthritis • Johns Hopkins Arthritis Center

The Combination of Leflunomide (Arava) and Methotrexate is Safe & Efficacious for the Treatment of Rheumatoid Arthritis • Johns Hopkins Arthritis Center