Publication Name	World Journal of Hepatology
Manuscript ID	113743
Country	Sweden

Category	Gastroenterology & Hepatology
Manuscript Type	Minireviews
Article Title	Should the theory of methotrexate-induced liver toxicity be abandoned?
Manuscript Source	Invited Manuscript
All Author List	Yahya Al-Hammada, Sinan Sharba and Samer Al-Dury
Funding Agency and Grant Number
Corresponding Author	Samer Al-Dury, MD, PhD, School of Public Health and Community Medicine, University of Gothenburg, Universitetsplatsen 1, Gothenburg 40530, Sweden. samer.al-dury@gu.se
Key Words	Risk stratification; Noninvasive monitoring; Metabolic risk factors; Hepatotoxicity; Liver fibrosis; Methotrexate
Core Tip	Methotrexate (MTX) has long been associated with a presumed risk of hepatotoxicity and progressive liver fibrosis, largely based on early biopsy-era studies. Contemporary evidence using non-invasive fibrosis assessment shows that significant fibrosis is uncommon in MTX-treated patients and more strongly linked to metabolic dysfunction-associated steatotic liver disease and related risk factors such as obesity, diabetes, and insulin resistance. This minireview challenges the traditional perception of intrinsic MTX hepatotoxicity and argues for risk-based rather than drug-based monitoring strategies.
Citation	Al-Hammada Y, Sharba S, Al-Dury S. Should the theory of methotrexate-induced liver toxicity be abandoned? World J Hepatol 2025; In press

Received	2025-09-10 08:35
Peer-Review Started	2025-09-10 08:36
First Decision by Editorial Office Director	2025-10-13 08:51
Return for Revision	2025-10-13 08:51
Revised	2025-10-21 06:13
Publication Fee Transferred
Second Decision by Editor	2025-12-16 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-16 09:33
Articles in Press	2025-12-16 09:33
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
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