Hepatoprotective effect of tumour necrosis factor α blockade in psoriatic arthritis: a cross-sectional study

Abstract

The results suggest a protective effect of TNFalpha inhibitors against the development of liver fibrosis in patients with PsA.

Hepatic steatosis, carotid plaques and achieving MDA in psoriatic arthritis patients starting TNF-α blockers treatment: a prospective study

“…These data are in line with previous literature data obtained on smaller size samples [3,5,6]. Further strengthening the link between cardiometabolic variables and inflammation, in a previous analysis on the present population, we have found that obesity (defined as a Body Mass Index > 30) is associated with a statistically significant increase in the risk of a poor treatment response in PsA subjects receiving TNF-α blockers [28].…”

“…In addition to joint manifestations, subjects with PsA exhibit an abnormally high cardiovascular (CV) risk and, in turn, risk of the metabolic syndrome (MetS), one of its major vascular risk factors (VRFs) [2,3]. Accordingly, as compared with healthy controls, PsA patients exhibit a higher than normal platelet reactivity [4] and a higher than normal prevalence of hepatic steatosis (HS) [5] and of carotid plaques (CPs) [6]. All these conditions are well known markers of atherosclerosis and of CV risk [7,8].…”

Recognizing and managing comorbidities in psoriatic arthritis

“…As noted above, obesity and diabetes, as well as pre-existing liver disease and cumulative MTX dose, are risk factors for liver toxicity in MTX users with psoriasis or RA [47,98]. However, a lower risk of liver fibrosis was found in patients treated with combination TNF-a inhibitor and MTX compared with MTX alone [100][101][102]. Finally, TNF-a inhibitors have been associated with LFT abnormalities in patients with RA.…”

Review of MR elastography applications and recent developments

“…For example, ROC analysis in one such study of 35 normal volunteers and 50 patients indicated that MRE had a 98% sensitivity and a 99% specificity for differentiating normal livers from all grades of liver fibrosis, and had a 86% sensitivity and a 85% specificity for differentiating patients with mild fibrosis from those with moderate and severe fibrosis (66). One recent application of dynamic hepatic MRE has been as a surrogate for liver biopsy to assess fibrosis in patients with arthritis and other inflammatory diseases undergoing treatment with methotrexate (MTX), which is known to be linked to liver toxicity and is normally monitored with routine biopsies (75–77). As a complement to dynamic MRE, a quasistatic MR tagging technique has also been shown to have potential as a means to measure fibrosis.…”