How long can a patient stay on Methotrexate?

Many patients with rheumatoid arthritis have stayed on this drug for 20 years or more. It used to be recommended that every patient who reached a certain lifetime dose of methotrexate receive a liver biopsy, but that is no longer recommended by rheumatology organizations as long as blood tests related to liver function remain normal. Some dermatology organizations remain concerned about liver damage in this setting, particularly in patients with psoriasis.

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