Infliximab-induced hepatitis: absence of cross-toxicity with etanercept

New onset idiosyncratic liver enzyme elevations with biological therapy in inflammatory bowel disease

“…Infliximab and adalimumab have been implicated in DILI in case reports and small case series predominantly in patients with rheumatological disorders. 10,[12][13][14][15][16][17][18][19][20][21] A population-based study from Iceland implicated infliximab as the most likely anti-TNF to cause DILI at a rate of 1 in 120, but included only 11 patients with liver injury. 22 The largest published series of 34 patients with 6 unique patients and 28 from the literature included only 12 patients with IBD, 11 due to infliximab and 1 related to adalimumab.…”

Successful Treatment with Etanercept of a Patient with Psoriatic Arthritis after Adalimumab-Related Hepatotoxicity

“…However, to date, concern still remains regarding acute and long-term toxicity related to TNF block (3). Although liver toxicity during anti-TNF treatment has been primarily associated with concomitant hepatotoxic drugs, infection, or malignant diseases (4), cases of liver injury directly related to anti-TNF drugs have been reported (5)(6).…”

Recurrent hepatotoxicity associated with etanercept and adalimumab but not with infliximab in a patient with rheumatoid arthritis

“…Previous published cases suggest absence of hepatic crosstoxicity between infliximab and etanercept (8,9), and between adalimumab and etanercept (7). This has been explained because these drugs are structurally different: etanercept is a soluble TNFreceptor fusion protein, and infliximab and adalimumab are chimeric IgG1 anti-TNF-a monoclonal antibodies and by the fact that polymorphisms have been identified in genes encoding proteins related to TNF-a (1,6).…”