Effect of Oral Methotrexate on Liver Function in Autoimmune Patients at Dr. Kariadi General Hospital, Semarang

Background: Methotrexate is a first-line therapy for various autoimmune diseases, particularly in rheumatology.However, its use is associated with potential hepatotoxicity, commonly reflected by elevations in serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT).This study aimed to evaluate the association between oral methotrexate dosing and its effects in patients with autoimmune disease, as reviewed by SGOT and SGPT values.Methods: This retrospective, descriptive observational study was conducted at Dr. Kariadi General Hospital, Semarang.Medical records of patients with autoimmune diseases receiving oral methotrexate therapy and attending the outpatient rheumatology department between December 1 and 31, 2024, were reviewed.Eighty patients met the inclusion criteria.The relationship between methotrexate dose and SGOT and SGPT levels was analyzed using one-way ANOVA, followed by Tukey's post hoc test when appropriate. Results:The mean SGOT value was 26.64 U/L (SD=12.27),with no significant differences among methotrexate dose groups (p =0.505).The mean SGPT level was 31.54U/L (SD=51.56)and showed a trend toward intergroup differences (p=0.064).Post hoc analysis revealed that a methotrexate dose of 12.5 mg/week was associated with significantly higher SGPT levels compared with a dose of 7.5 mg/week (p=0.041). Conclusion:Oral methotrexate therapy may be associated with increased liver enzyme levels, particularly SGPT, even at low to moderate doses, whereas SGOT appears less affected by dose variations.These findings underscore the importance of regular liver function monitoring during methotrexate therapy.