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Response to: Quantifying the hepatotoxic risk of alcohol consumption in patients with rheumatoid arthritis by Kremer and Weinblatt
  1. Jenny H Humphreys1,
  2. Ruth Costello1,
  3. Suzanne MM Verstappen1,2,
  4. William G Dixon1
  1. 1Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK
  2. 2NIHR Biomedical Research Centre, University of Manchester, Manchester, UK
  1. Correspondence to Dr William G Dixon, NIHR Biomedical Research Centre, University of Manchester, Manchester M13 9PT, UK; will.dixon{at}manchester.ac.uk

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We thank Drs Kremer and Weinblatt for their interest in our study.1 We agree and acknowledge that lack of biopsies and detailed histology is a limitation of our study.2 Unfortunately good quality data on liver biopsies and ultrasound scans were not available in this retrospective observational study and would not have been systematically performed in all patients, necessitating the use of serum liver function tests (LFTs). However this limitation is balanced against our ability to study a rare outcome in a large number of people. The strengths of observational data are that they reflect ‘real-life’ usage versus a carefully monitored research cohort, and this …

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