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We found a 6% incidence of moderate (\u22651.5 \u00d7 the upper limit of normal) elevations in aspartate aminotransferase or alanine aminotransferase over a mean followup period of 7 months. We identified predictors of moderate transaminase elevations to include obesity (per body mass index \u226530 kg\/m<jats:sup>2<\/jats:sup>), total cholesterol &gt;240 mg\/dl, pre\u2010MTX liver function test (LFT) elevations, use of biologic agents, and lack of folic acid supplementation. A patient with these characteristics and &gt;3 comorbid conditions would be predicted to have a 90% chance of developing a moderate transaminase elevation in the 7 months after starting MTX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Moderate LFT abnormalities were uncommon in the first 7 months of MTX use, but were more likely to occur in patients with obesity, untreated high cholesterol, pre\u2010MTX LFT elevations, biologic agent use, and lack of folic acid supplementation. Future work should aim to develop a robust, automated prediction rule for identifying patients at high risk for MTX\u2010related liver toxicity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22294","type":"journal-article","created":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T14:11:14Z","timestamp":1390831874000},"page":"1159-1166","source":"Crossref","is-referenced-by-count":69,"title":["Identification of Risk Factors for Elevated Transaminases in Methotrexate Users Through an Electronic Health Record"],"prefix":"10.1002","volume":"66","author":[{"given":"Gabriela","family":"Schmajuk","sequence":"first","affiliation":[{"name":"Veterans Affairs Medical Center and University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghui","family":"Miao","sequence":"additional","affiliation":[{"name":"Veterans Affairs Medical Center San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinoos","family":"Yazdany","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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