Remission of Rheumatoid Arthritis and Primary Biliary Cholangitis After Treatment With Tocilizumab

Azevedo, Soraia; Sousa-Neves, Joana; Rodrigues, Joana Ramos; Peixoto, Daniela; Tavares-Costa, José; Teixeira, Filipa

doi:10.1016/j.reuma.2020.04.014

Cited by 2 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, if the pharmacological target is discovered in the pathogenesis of the two diseases, optimized management of one might possibly bene t the other. Novel effective medications (e.g., in iximab, rituximab, abatacept, and tocilizumab) hold considerable promise for the treatment of both PBC and RA [29][30][31][32]. Several have received preliminary approval, thereby increasing the likelihood that they will be identi ed and con rmed as bene cial.…”

Section: Discussionmentioning

confidence: 99%

Genetic Link Between Primary Biliary Cholangitis and Rheumatoid Arthritis: A Two-Sample Mendelian Randomization Study

Fan

Jiang

2022

Preprint

View full text Add to dashboard Cite

Background Although observational studies have shown that primary biliary cholangitis (PBC) and rheumatoid arthritis (RA) frequently coincide, it is unclear whether a causative relationship exists between the two diseases. This study aimed to assess the causal associations between PBC and RA. Methods We performed a two-sample Mendelian randomization (MR) analysis. Following a strict assessment, genome-wide association study datasets were used to select potential candidate single-nucleotide polymorphisms. Sensitivity analyses were performed to determine whether the MR results were affected by heterogeneity and pleiotropy. Results We found that genetically increased PBC risk had a positive causal effect on RA (inverse-variance weighted odds ratio [IVW OR] 1.149, 95% confidence interval [CI] 1.063–1.241, P < 0.001). Horizontal pleiotropy was unlikely to influence causation according to the MR-Egger regression (intercept=-0.028, P = 0.263). Sensitivity analyses using the leave-one-out method further confirmed that the MR analysis results were reliable and robust. In contrast, the reverse MR analysis found no evidence of a causal effect of RA on PBC (IVW OR 1.132, 95% CI 0.881–1.454, P = 0.333). Conclusions Our findings provide evidence that PBC has a unidirectional effect on RA in the European population. Given the increased risk of PBC in RA and both being autoimmune conditions, awareness and thorough screening are imperative in clinical practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Genetic Link Between Primary Biliary Cholangitis and Rheumatoid Arthritis: A Two-Sample Mendelian Randomization Study

Fan

Jiang

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…MiR-200c restrained the proliferative and neuroendocrine-like activation of cholangiocytes by targeting Sestrins1 and inhibiting the IL-6/AKT feedback loop to protect against cholestatic liver fibrosis ( 43 ). In this line, tocilizumab was found effective and safe in the treatment of rheumatoid arthritis (RA) in patients with PBC ( 44 ). However, there is currently only a case report available for this treatment approach, and there have been no clinical trials conducted to investigate its efficacy.…”

Section: Novel Advances Targeting Immune Factorsmentioning

confidence: 99%

Mechanism-based target therapy in primary biliary cholangitis: opportunities before liver cirrhosis?

Yang

Rojas

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

Primary biliary cholangitis (PBC) is an immune-mediated liver disease characterized by cholestasis, biliary injuries, liver fibrosis, and chronic non-suppurative cholangitis. The pathogenesis of PBC is multifactorial and involves immune dysregulation, abnormal bile metabolism, and progressive fibrosis, ultimately leading to cirrhosis and liver failure. Ursodeoxycholic acid (UDCA) and obeticholic acid (OCA) are currently used as first- and second-line treatments, respectively. However, many patients do not respond adequately to UDCA, and the long-term effects of these drugs are limited. Recent research has advanced our understanding the mechanisms of pathogenesis in PBC and greatly facilitated development of novel drugs to target mechanistic checkpoints. Animal studies and clinical trials of pipeline drugs have yielded promising results in slowing disease progression. Targeting immune mediated pathogenesis and anti-inflammatory therapies are focused on the early stage, while anti-cholestatic and anti-fibrotic therapies are emphasized in the late stage of disease, which is characterized by fibrosis and cirrhosis development. Nonetheless, it is worth noting that currently, there exists a dearth of therapeutic options that can effectively impede the progression of the disease to its terminal stages. Hence, there is an urgent need for further research aimed at investigating the underlying pathophysiology mechanisms with potential therapeutic effects. This review highlights our current knowledge of the underlying immunological and cellular mechanisms of pathogenesis in PBC. Further, we also address current mechanism-based target therapies for PBC and potential therapeutic strategies to improve the efficacy of existing treatments.

show abstract

Remission of Rheumatoid Arthritis and Primary Biliary Cholangitis After Treatment With Tocilizumab

Cited by 2 publications

References 5 publications

Genetic Link Between Primary Biliary Cholangitis and Rheumatoid Arthritis: A Two-Sample Mendelian Randomization Study

Genetic Link Between Primary Biliary Cholangitis and Rheumatoid Arthritis: A Two-Sample Mendelian Randomization Study

Mechanism-based target therapy in primary biliary cholangitis: opportunities before liver cirrhosis?

Contact Info

Product

Resources

About