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Glimelius B, Manojlovic N, Pfeiffer P, et al

5) While some associations have been observed, particularly with gout and renal diseases, evidence from Mendelian randomization studies did not consistently support a causal relationship between elevated serum urate levels and other metabolic or cardiovascular disorders

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If methotrexate absorption changes unpredictably, the patient faces either inadequate immunosuppression or toxicity