Safety of TNF inhibitors in rheumatic disease in case of NAFLD and cirrhosis.

Abstract

The management of inflammatory rheumatic diseases has substantially changed in recent years, as has the profile of patients. The advent of biotherapies has been a revolution in rheumatology and the impact of co-morbidities in the management of these patients is now becoming increasingly important. Metabolic syndrome (MetS) is one of the most frequent comorbidities, and hepatic complications of MetS are not uncommon. MetS is responsible for Non-alcoholic fatty liver disease (NAFLD), characterized by excessive hepatic fat accumulation. In extreme cases, progression to cirrhosis is possible. NAFLD ranks among the top three indications for liver transplantation. We review available data on the safety, especially the risk of infections, of TNF inhibitors (TNFi) in case of NAFLD and in case of liver cirrhosis, in patients with rheumatic disease. In cases of NAFLD without severe fibrosis, available data are reassuring and tend to show a beneficial effect of TNFi on hepatic tissue. In case of cirrhosis, data are conflicting. Further large, well-designed studies are needed to explore this specific issue.

• Authors: Frank Verhoeven, Delphine Weil-Verhoeven, Clément Prati, Vincent Di Martino, Thierry Thevenot, Daniel Wendling
• Journal: Seminars in arthritis and rheumatism (Semin Arthritis Rheum) Vol. 50 Issue 4 Pg. 544-548 (08 2020) ISSN: 1532-866X [Electronic] United States
• PMID: 32446022 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Tumor Necrosis Factor Inhibitors

Topics

• Adult
• Aged
• Female
• Humans
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease (complications)
• Rheumatic Diseases (complications, drug therapy)
• Tumor Necrosis Factor Inhibitors (administration & dosage, adverse effects)