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Methotrexate-induced liver enzyme elevations often resolve with temporary withdrawal or folic acid supplementation, which mitigates hepatic toxicity without compromising efficacy (Balak et al

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At the same time, the metabolites such as succinic acid, l-phenylalanine, l-arginine, and l-glycine decreased, and amino acid metabolism and energy metabolism were disturbed, which was similar to the findings of Shen et al

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