RESEARCH - Hepatoprotective effect of TNF blockade in psoriatic arthritis

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Ann Rheum Dis. Published Online First: 22 October 2009.

doi:10.1136/ard.2009.116194

Hepatoprotective effect of TNF blockade in psoriatic arthritis: A

cross-sectional study

Seitz1,*, Stephan Reichenbach1, Burkhard Möller1, Marcel

Zwahlen2, M Villiger1, Jean-Francois Dufour3

1 Department of Rheumatology, Clinical Immunology & Alllergology,

University Hospital Bern, Switzerland;

2 Institutte of Social and Preventive Medicine, University of Bern,

Switzerland;

3 Institute of Clinical Pharmacology and Visceral Research, University

of Bern, Switzerland

ABSTRACT

Objective: To evaluate the impact of TNF blockers on the presence of

liver fibrosis in patients with rheumatoid arthritis (RA) and

psoriatic arthritis (PsA) treated with methotrexate (MTX).

Methods: Subjects were consecutive patients with RA and PsA who had

undergone MTX treatment for at least one year +/- TNF blockade for

over 6 months. Liver fibrosis was assessed using non-invasive

transient elastography (FibroScan). Regression models were used to

compare FibroScan values of RA and PsA patients receiving TNF blockers

with those who were not.

Results: FibroScan assessments were performed on 51 RA and 43 PsA

patients. Compared to RA patients, those with PsA were predominantly

young males, received lower cumulative dosages of MTX and exhibited a

higher incidence of liver steatosis and hyperlipidemia. An abnormal

result was observed in 7.1% of the anti-TNF-naïve and in 13% of the

anti-TNF-treated patients in the RA group, and in 30% of the

anti-TNF-naïve and 4.3% of the anti-TNF-treated patients in the PsA

group (OR = 0.11, 95% CI 0.02 to 0.98). Results of the PsA group were

robust when adjusted for baseline characteristics.

Conclusion: The results suggest a protective effect of TNF inhibitors

against the development of liver fibrosis in patients with PsA.

http://ard.bmj.com/cgi/content/abstract/ard.2009.116194v1?papetoc

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