Abstract
Anti-tumour necrosis factor α (anti-TNF) agents have been implicated in drug-induced liver injury. There is minimal data on this occurrence in inflammatory bowel disease (IBD) patients. To identify the characteristics of liver enzyme elevations following anti-TNF therapy initiation in IBD. A retrospective cohort of patients initiating anti-TNF therapy were analysed for new onset alanine transaminase (ALT) elevation (≥60 U/L). We collected data on natural history, outcomes and patient characteristics compared with controls with persistent normal liver enzymes. Likelihood of causal association was assessed using the RUCAM score. From 1753 patients initiating an anti-TNF (1170 infliximab, 575 adalimumab, 8 certolizumab), 102 (6%) developed new onset ALT elevation. In 54 (53%), this could be linked to an alternate aetiology. Among those with idiopathic ALT elevations, the median time to ALT elevation from anti-TNF initiation was 18 weeks and median peak ALT was 96 U/L. Six underwent liver biopsy, all demonstrating hepatitis with autoimmune features. Compared to controls, cases were on a lower dose of infliximab (5.7 vs. 6.7 mg/kg, P = 0.02) but were otherwise similar in body mass index, sex and age. On follow-up, 34 continued the a...Continue Reading
References
Nov 1, 1993·Journal of Clinical Epidemiology·C BenichouA Flahault
Aug 18, 2001·Arthritis and Rheumatism·G SaleemS M Cooper
Jun 6, 2002·Lancet·Stephen B HanauerUNKNOWN ACCENT I Study Group
Oct 24, 2003·The American Journal of Gastroenterology·Brian G FeaganGary R Lichtenstein
Dec 23, 2003·The American Journal of Gastroenterology·Gary R LichtensteinStephen Hanauer
Sep 16, 2005·Annals of the Rheumatic Diseases·V GermanoG Valesini
Dec 13, 2005·The New England Journal of Medicine·Paul RutgeertsJean Frédéric Colombel
Jan 31, 2006·Alimentary Pharmacology & Therapeutics·P RutgeertsS Vermeire
Mar 21, 2006·Clinical Rheumatology·Gabriel J TobonJuan-Manuel Anaya
May 18, 2006·JAMA : the Journal of the American Medical Association·Tim BongartzVictor Montori
Nov 6, 2007·The Medical Journal of Australia·Gerard OzorioCathy Marshall
Aug 12, 2008·Joint, Bone, Spine : Revue Du Rhumatisme·Gérard ThiéfinJean-Paul Eschard
Nov 26, 2008·Best Practice & Research. Clinical Rheumatology·Manuel Ramos-CasalsMunther A Khamashta
Apr 17, 2009·Clinical Rheumatology·K M CarlsenO R Madsen
Jul 14, 2009·Journal of Clinical Gastroenterology·Tomer AdarOren Shibolet
Mar 2, 2010·Gastroentérologie Clinique Et Biologique·A HaennigL Alric
Jul 17, 2010·Journal of the American Academy of Dermatology·Catherine GoujonJean-François Nicolas
Mar 17, 2011·The American Journal of Gastroenterology·Alexander C FordPaul Moayyedi
May 18, 2011·Journal of Crohn's & Colitis·Adam DoyleNick Kontorinis
Oct 12, 2011·Inflammatory Bowel Diseases·K SubramaniamP Pavli
Dec 30, 2011·European Journal of Clinical Pharmacology·A GraslandI Mahe
May 19, 2012·Inflammatory Bowel Diseases·Amit DesaiAshwin N Ananthakrishnan
Jul 13, 2012·Alimentary Pharmacology & Therapeutics·P S A de SilvaA N Ananthakrishnan
Aug 15, 2012·The American Journal of Gastroenterology·Gary R LichtensteinWilliam J Sandborn
Jan 22, 2013·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Marwan GhabrilUNKNOWN US Drug-Induced Liver Injury Network
Feb 20, 2013·The American Journal of Gastroenterology·Emily C OxfordAshwin N Ananthakrishnan
Sep 11, 2013·Case Reports in Dermatology·Hassan RiadMariam Al Mansoori
Jun 12, 2014·Inflammatory Bowel Diseases·Alice G ChengAshwin N Ananthakrishnan
Aug 19, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Einar S BjörnssonSigurdur Olafsson
Sep 16, 2014·Inflammatory Bowel Diseases·Bikash Devaraj, Andreas M Kaiser
Citations
Dec 23, 2015·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Joshua B FrenchHerbert L Bonkovsky
Nov 7, 2015·Alimentary Pharmacology & Therapeutics·V GuptaA N Ananthakrishnan
May 5, 2016·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Philip SargesJames H Lewis
Nov 8, 2016·Case Reports in Hepatology·Gary Golds, Lawrence Worobetz
Oct 7, 2016·Liver International : Official Journal of the International Association for the Study of the Liver·Sophie RestelliniJean-Louis Frossard
Oct 26, 2016·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Xinyang LiZhihua Ran
Feb 3, 2016·Journal of Pediatric Gastroenterology and Nutrition·Shikib MostamandTamir Miloh
Feb 27, 2016·Inflammatory Bowel Diseases·Priya SehgalNeeraj Narula
Aug 3, 2016·Inflammatory Bowel Diseases·Cindy C Y LawAshwin N Ananthakrishnan
Jul 24, 2018·Journal of Clinical Gastroenterology·Lucy Shamberg, Haleh Vaziri
Oct 13, 2018·Inflammatory Bowel Diseases·Benjamin Click, Miguel Regueiro
Dec 25, 2019·The Korean Journal of Internal Medicine·Su Jin ChoiYong-Gil Kim
Dec 9, 2015·World Journal of Hepatology·Robert HirtenDavid E Bernstein
Mar 23, 2018·Digestive Diseases and Sciences·Beverley KokUNKNOWN United States Acute Liver Failure Study Group
Aug 1, 2018·International Journal of Molecular Sciences·Loris Riccardo LopetusoAlfredo Papa
Jan 13, 2019·Current Gastroenterology Reports·Benjamin Click, Miguel Regueiro
May 26, 2017·World Journal of Hepatology·My-Linh Tran-MinhJean-Marc Gornet
Jun 28, 2017·World Journal of Gastroenterology : WJG·Tomas KollerJuraj Payer
Jul 19, 2019·Case Reports in Rheumatology·Benedicta Nneoma NnodumLauren Dudley
Feb 7, 2020·Hepatology Communications·Parth ShahEinar Björnsson
Apr 5, 2019·BMC Gastroenterology·Fotios S FousekisDimitrios K Christodoulou
Dec 18, 2019·Physiological Research·K BrazdilovaJ Payer
Jun 24, 2018·Digestive Diseases and Sciences·Christina LingDenis M McCarthy
Dec 16, 2020·Clinical Liver Disease·Elizabeth S AbyByron P Vaughn
May 20, 2021·ACG Case Reports Journal·Muhammed Mustafa AlikhanJeffry Katz