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Study: Patients with RA on MTX can have fewer than 14 drinks per week without increased transaminitis risk
In patients with rheumatoid arthritis who took methotrexate, a weekly alcohol consumption of fewer than 14 drinks was not associated with hepatotoxicity, as defined by the U.K. national guidelines, according to recently published data.
Jenny H. Humphreys, PhD, at the Arthritis Research UK Centre for Epidemiology at the University of Manchester, and colleagues assessed 11,839 patients diagnosed with rheumatoid arthritis (RA) between 1987 and 2016. Researchers defined hepatotoxicity as transaminitis, which is an alanine transaminase or aspartate aminotransferase level greater than three-times the upper limit of normal. They calculated transaminitis rates per 1,000 person-years and categorized them by weekly alcohol drink consumption, with a drink defined as one that contains 10 mL of pure alcohol.
Overall, there were 530 cases of transaminitis in 47,090 person-years of follow-up. Researchers found increased weekly alcohol consumption correlated with increased risk for transaminitis per unit consumed (ratio = 1.01). Consumption between 15 drinks and 21 drinks (ratio = 1.35) and consumption of more than 21 drinks (ratio = 1.85) were associated with increased risk of transaminitis. However, there was no increased risk for consumption of fewer than 14 drinks per week.
“This may provide the practical and useful information that drinking alcohol within nationally recommended levels in the U.K. is safe, in terms of risk of transaminitis, for patients commencing [methotrexate] MTX therapy for RA," the researchers wrote. "Our study was conducted only in patients with RA and thus cannot be automatically generalizable to other populations.” – by Will Offit
Disclosure: Researchers report no relevant financial disclosures.
Editor’s note: On April 3, 2017, we corrected this article to clarify the definition of a standard unit of alcohol as defined in the published study. In the United Kingdom, the standard value of a unit of alcohol is 10 mL (7.9 g), which equals 17.7 mL (14 g) in the United States. Therefore, 14 drinks in the United Kingdom are equivalent to 7.89 drinks in the United States.