Hepatic complications induced by immunosuppressants and biologics in inflammatory bowel disease

Tran‐Minh, My‐Linh; Sousa, Paula; Maillet, Marianne; Allez, Matthieu; Gornet, Jean–Marc

doi:10.4254/wjh.v9.i13.613

Cited by 26 publications

(33 citation statements)

References 180 publications

(209 reference statements)

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“…Additionally, MTX damages the intestinal mucosa, thereby disrupting the intestinal barrier functionality and allowing bacterial translocation to the liver to induce hepatotoxicity (Song et al, 2006; Duman et al, 2013). The increase in intestinal permeability is positively correlated with diarrhea, and MTX-induced high permeability significantly participates in liver inflammation (Tran-Minh et al, 2017). Interestingly, Hu et al (2003) demonstrated that MgIG is mainly excreted into bile in unchanged form.…”

Section: Introductionmentioning

confidence: 99%

Protective Effects of Magnesium Glycyrrhizinate on Methotrexate-Induced Hepatotoxicity and Intestinal Toxicity May Be by Reducing COX-2

et al. 2019

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Magnesium isoglycyrrhizinate (MgIG), which has been widely employed to treat chronic hepatitis, is synthesized from 18-β glycyrrhizic acid, a main component of traditional Chinese medicine Glycyrrhiza uralensis Fisch. Although the protective effects of MgIG on methotrexate (MTX)-induced liver toxicity have been well-documented, the underlying mechanism remains elusive. MTX was initially used to treat pediatric acute leukemia, and has been widely applied to psoriasis therapy. However, its clinical applications are limited due to hepatotoxicity and intestinal toxicity. Herein, prophylactic administration of MgIG (9 and 18 mg/kg/day) significantly reduced the levels of aspartate aminotransferase and alanine aminotransferase in the serum of rats receiving intravenous injection of MTX (20 mg/kg body weight). MgIG also attenuated MTX-induced hepatic fibrosis. Moreover, it better protected against MTX-induced hepatocyte apoptosis and decreased the serum level of malondialdehyde than reduced glutathione (80 mg/kg/day) did. Interestingly, MTX-induced cyclooxygenase-2 (COX-2) expression, intestinal permeability and inflammation were attenuated after MgIG administration. In addition, MgIG (9 and 18 mg/kg) reduced MTX-induced colocalization of zonula occludens-1 (ZO-1) and connexin 43 (Cx43) in intestinal villi. In conclusion, MgIG exerted beneficial effects on MTX-induced hepatotoxicity and intestinal damage, as a potentially eligible drug for alleviating the hepatic and intestinal side effects of MTX during chemotherapy.

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Section: Introductionmentioning

confidence: 99%

Protective Effects of Magnesium Glycyrrhizinate on Methotrexate-Induced Hepatotoxicity and Intestinal Toxicity May Be by Reducing COX-2

et al. 2019

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“…According to a French review in 2017, biological agents may increase liver enzymes. However, their concentrations often vary slightly and return to normal values within continued treatment [27]. The results of this study suggest that changes in ALT, AST and ALP mean concentrations varied in reference ranges, when GGT concentration increased less than two-fold during the first 5 years of treatment, returning to the reference range of 33.4 mmol/L after 6 years of treatment.…”

Section: Changes In Laboratory and Instrumental Testsmentioning

confidence: 59%

A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology

et al. 2020

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Background and Objectives: Biological therapy is widely used for the treatment of severe psoriasis. The objective of this study was to evaluate the efficacy and safety of biological therapy for patients with severe psoriasis. Materials and Methods: A retrospective study of 79 patients with severe psoriasis, who have been treated with biological therapy between 2012 and 2018, was conducted. During this study, the following data were collected and evaluated: sex, age, body mass index (BMI), duration of illness, the results of treatment with biological therapy, concomitant therapy, Psoriasis Area and Severity Index (PASI) and adverse events. Results: In total, 74.7% (n = 59) of subjects were male. Their overall average age was 47.4 ± 11.4 (range: 18–73) years. Their baseline BMI was 27.6 ± 5.9, which increased to 29.6 ± 4.5 after 6 years of treatment. The mean duration of psoriasis was 25.7 ± 12.5 years. In total, 39.2% (n = 31) of subjects received infliximab, 36.7% (n = 29)—etanercept, 24.1% (n = 19)—ustekinumab. The treatment duration for infliximab, etanercept and ustekinumab was 201.6 ± 86.8, 156.2 ± 137.4 and 219.1 ± 95.7 weeks (p < 0.01), respectively. Overall, 65.8% (n = 52) of subjects were also on methotrexate; 30.8% (n = 16) of them discontinued it due to clinical improvement (31.3% (n = 5)), impaired liver function (31.3% (n = 5)), and intolerance (25% (n = 4)). Baseline PASI was 20.8 ± 8.8. PASI 50 was achieved by 96.2% (n = 76) of patients at week 11, PASI 75 by 86.1% (n = 68) at week 16, PASI 90 by 54.4% (n = 43) at week 35, and PASI 100 by 13.9% (n = 11) at week 33. The overall incidence rate of adverse events was 0.362 per patient year of follow-up. Conclusion: Biological therapy is an effective and safe treatment for patients with severe psoriasis.

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“…11 Moreover, the rate of reactivation of hepatitis B and C viruses appears to be lower for tacrolimus than for systemic corticosteroids. [12][13][14][15][16] A meta-analysis assess-…”

Section: Discussionmentioning

confidence: 99%

“… 11 Moreover, the rate of reactivation of hepatitis B and C viruses appears to be lower for tacrolimus than for systemic corticosteroids. 12 13 14 15 16 A meta-analysis assessing the risk of adverse events in patients with systemic lupus erythematosus found that the rate of serious adverse events was lower for tacrolimus than for other immunosuppressants such as glucocorticoids, cyclosporine, azathioprine, cyclophosphamide, mycophenolate mofetil, methotrexate, and rituximab. 17 Tacrolimus was also suitable for controlling ocular inflammatory diseases including Behçet's disease and Vogt-Koyanagi-Harada syndrome without inducing increases in infection and malignancy.…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus for Treating Orbital and Cranial Form of Idiopathic Inflammatory Pseudotumors

et al. 2020

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Background and Purpose Orbital and cranial form of idiopathic inflammatory pseudotumors (IIPs) are rare disorders with heterogeneous clinical presentations. Corticosteroids have been the first-line treatment for IIPs, but they are not always effective. Methods We reviewed the medical records of three patients with orbital or cranial form of IIP who were treated with tacrolimus as an adjuvant treatment. Results The three patients showed favorable outcomes with the addition of tacrolimus, which is a calcineurin inhibitor that inhibits T-cell activation and T-cell-dependent B-cell activation. Conclusions Tacrolimus may be a safe and effective immunosuppressant for refractory or relapsing form of orbital or cranial IIPs.

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Hepatic complications induced by immunosuppressants and biologics in inflammatory bowel disease

Cited by 26 publications

References 180 publications

Protective Effects of Magnesium Glycyrrhizinate on Methotrexate-Induced Hepatotoxicity and Intestinal Toxicity May Be by Reducing COX-2

Protective Effects of Magnesium Glycyrrhizinate on Methotrexate-Induced Hepatotoxicity and Intestinal Toxicity May Be by Reducing COX-2

A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology

Tacrolimus for Treating Orbital and Cranial Form of Idiopathic Inflammatory Pseudotumors

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