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Hepatoprotective effect of TNF-alpha blockade in psoriatic arthritis: A cross-sectional study
Annals of Rheumatic Diseases, 11/09/09
Seitz M et al. – The results of this study suggest a protective effect of TNF &alpha inhibitors against the development of liver fibrosis in patients with PsA.
Methods- Consecutive patients with RA and PsA who had undergone MTX treatment for at least 1 y +/- TNF blockade for over 6 mos
- Liver fibrosis assessed using non-invasive transient elastography (FibroScan)
- Regression models used to compare FibroScan values of RA and PsA patients receiving TNF &alpha blockers with those who were not
- FibroScan assessments performed on 51 RA and 43 PsA patients
- Compared to RA patients, those with PsA predominantly young males, received lower cumulative dosages of MTX and exhibited higher incidence of liver steatosis and hyperlipidemia
- Abnormal result observed in 7.1% of anti-TNF-naïve and 13% of anti-TNF-treated patients in RA group, and in 30% of anti-TNF-naïve and 4.3% of anti-TNF-treated patients in PsA group (OR = 0.11, 95% CI 0.02 to 0.98)
- Results of PsA group were robust when adjusted for baseline characteristics
Exclusive Author Commentary
Michael Seitz, 11/10/09
Michael Seitz, 11/10/09
| This study provides first preliminary hint that TNF-blockade might be prevent liver fibrosis in patients with psoriatic arthritis undergoing longterm methotrexate treatment and exhibiting enhanced co-morbidity such as liver steatosis, dyslipidemia, diabetes mellitus that might predisose patients to enhanced hepatotoxicity |
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