We would recommend that people who take methotrexate to speak to their rheumatologist for advice about drinking alcohol whilst on this drug.”
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Dr Jenny Humphreys, an NIHR Clinical Lecturer at The University of Manchester’s Arthritis Research UK Centre for Epidemiology, led the study.
She said: “In the past there’s not been clear guidance on what effects different amounts of alcohol have on these people, so doctors often err on the side of caution and recommend abstinence.
“As a result, some people choose to decline methotrexate so they can continue to enjoy a drink, thereby missing out on the possible benefits of the medication.
“Alternatively, some people may go totally without alcohol after starting methotrexate: if they like to drink in moderation, the quality of their life may be affected.”
The researchers identified 11,839 people with rheumatoid arthritis who were taking methotrexate and had at least six liver function test results per year. Of these, 530 developed abnormal liver function tests.
Although there was no increased risk associated with drinking 14 units or less compared to people who drank no alcohol, people who drank 15-21 units had a 33 per cent increased probability of liver damage and this rose to 81 per cent in the group that drank more than 21 units.
Professor Will Dixon, Director of the Arthritis Research UK Centre for Epidemiology at The University of Manchester, believes that the results can provide important guidance for doctors who are prescribing methotrexate.
He added: “This is the first study to provide estimates of risk of liver damage for different levels of alcohol consumption in this drug.
It also quantifies the risk for doctors so they can be clear about the extent to which different levels of alcohol will cause problems across a population of patients taking methotrexate.
The research was published in the journal Annals of the Rheumatic Diseases and funded by Arthritis Research UK.