Improvement of Rheumatoid Arthritis and Autoimmune Hepatitis in a Patient Treated with the Tumor Necrosis Factor Inhibitor, Etanercept

Umekita, Kunihiko; Miyauchi, Satoru; Ueno, Shiro; Takajo, Ichiro; Kusumoto, Kazunori; Hasuike, Satoru; Umekita, Yoshiko; Tanaka, Hiroyuki; Nagata, Kenji; Nagatomo, Yasuhiro; Kataoka, Hiroaki; Shimoda, Kazuya; Okayama, Akira

doi:10.2169/internalmedicine.50.4879

Cited by 8 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Single case reports with and without comorbidities demonstrate improving liver enzymes under infliximab treatment in adult [128,129] and pediatric patients [130] (as well as one report regarding etanercept [131]).…”

Section: Infliximabmentioning

confidence: 92%

Autoimmune Hepatitis: a Review of Established and Evolving Treatments

Bischoff

Yesmembetov

Antoni

et al. 2020

JGLD

View full text Add to dashboard Cite

Autoimmune hepatitis (AIH) is a necroinflammatory liver disease commonly presenting with a fluctuating course of activity, presence of circulating autoantibodies, hyperglobulinemia of IgG, and/or response to immunosuppressive drugs. However, the disease displays a considerable heterogeneity. No single clinical or biochemical test may establish diagnosis of AIH. Thus, diagnosis still requires extensive clinical evaluation and experience. Prednisolone and azathioprine are considered standard treatment leading to remission in most patients. However, this standard treatment may not be effective in some patients or not be feasible due to one of these drugs. Over the past two decades additional immunosuppressant drugs for the treatment of AIH have been evaluated and have significantly extended the therapeutic spectrum. Among those novel drugs are mycophenolate mofetil, tacrolimus, everolimus, 6-mercaptopurine, infliximab, rituximab and several others. In this review we summarize the current standard of therapy but also efforts of providing novel therapeutic strategies to AIH patients.

show abstract

Section: Infliximabmentioning

confidence: 92%

Autoimmune Hepatitis: a Review of Established and Evolving Treatments

Bischoff

Yesmembetov

Antoni

et al. 2020

JGLD

View full text Add to dashboard Cite

show abstract

“…There is some emerging evidence that anti-TNF antibodies are capable of inducing remission in AIH patients in whom standard or alternative therapeutic options have been exhausted [34,35]. However, the development of AIH has also been observed under treatment with anti-TNF antibodies [36].…”

Section: Anti-tnf-α Antibodiesmentioning

confidence: 99%

Autoimmune Hepatitis

Strassburg¹

2013

Dig Dis

View full text Add to dashboard Cite

Autoimmune hepatitis (AIH) was the first chronic liver disease in which remission was achieved by immunosuppression. Prognosis is poor when left untreated. Since the original description in 1950 by Waldenström, the initially reported treatment option has remained until today and is the core of the basic therapeutic strategy of inducing remission with steroids and azathioprine. Immunosuppression as a treatment concept spans different situations including the induction and maintenance of remission, treatment of nonresponders, avoidance of side effects, perioperative treatment of liver transplantation candidates and the issue of withdrawal. Alternative immunosuppressive drugs such as transplantation immunosuppressants have been administered and reported in small series. In an attempt to optimize side effect management, a recent large multicenter prospective treatment trial suggests that budesonide may offer an alternative for noncirrhotic AIH patients with lower steroid side effects. With an early diagnosis and effective therapy, only 4% of transplant candidates are transplanted for AIH. After liver transplantation there is a considerable risk for graft loss because of recurrent AIH, and lifelong vigilance and therapeutic attention is important.

show abstract

“…Anecdotal reports suggest that some patients with difficult AIH may respond to anti-TNF therapy and some patients with AIH and IBD have been reported as showing improvement in hepatitis when the IBD is treated with anti-TNFα therapy. However, despite these encouraging anecdotes, other reports have recorded AIH as a side effect of anti-TNF therapies [Coffin et al 2011;Jansen, 2010;Umekita et al 2011]. Thus further evidence of efficacy and toxicity is required before such therapies can be recommended.…”

Section: Biological Therapies For Autoimmune Hepatitismentioning

confidence: 99%

“…However, despite these encouraging anecdotes, other reports have recorded AIH as a side effect of anti-TNF therapies [Coffin et al . 2011; Jansen, 2010; Umekita et al . 2011].…”

Section: Autoimmune Hepatitis That Does Not Respond To Conventional Tmentioning

confidence: 99%

Management of patients with difficult autoimmune hepatitis

Parker

Adams

2012

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Autoimmune hepatitis (AIH) is characterized by a T-cell rich infiltrate associated with lobular and interface hepatitis, hypergammaglobulinemia and production of autoantibodies. Genetic risk is linked to the HLA particularly DRB1*0301 and DRB1*0401 alleles in North American and European Caucasian populations. It has recently been suggested that functional deficiencies in CD4 + CD25 + CD127 low FOXP3 + regulatory T cells contribute to the breakdown of immune tolerance that results in AIH. Most patients respond to immunosuppressive therapy with corticosteroids and can be maintained in remission by low-dose corticosteroid treatment and/or azathioprine. For those who progress to end-stage disease liver transplantation is an effective treatment although it is associated with recurrence. In the future it is likely that biological therapies will allow more targeted therapy designed to switch the balance to immune regulation and thereby restore immune homeostasis. Although treatment for many cases is relatively straightforward and successful problems are encountered in those who fail to respond to standard treatment, are unable to tolerate it or relapse. In such cases alternative therapies should be considered. In addition treatment is complicated in some patients by comorbidity and special care is required during and after pregnancy. We will discuss the current and future therapeutic options for patients with difficult to treat AIH.

show abstract

Improvement of Rheumatoid Arthritis and Autoimmune Hepatitis in a Patient Treated with the Tumor Necrosis Factor Inhibitor, Etanercept

Cited by 8 publications

References 22 publications

Autoimmune Hepatitis: a Review of Established and Evolving Treatments

Autoimmune Hepatitis: a Review of Established and Evolving Treatments

Autoimmune Hepatitis

Management of patients with difficult autoimmune hepatitis

Contact Info

Product

Resources

About