Drug-Induced Liver Injury Caused by Adalimumab: A Case Report and Review of the Bibliography

Frider, Bernardo; Bruno, Andrés; Ponte, M.; Amante, Marcelo

doi:10.1155/2013/406901

Cited by 8 publications

(10 citation statements)

References 23 publications

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“…Six months later Adalimumab was discontinued, and the patient's GGT and ALP elevations resolved. The authors concluded that the immediate resolution of these elevations upon discontinuation of Adalimumab is highly suggestive that Adalimumab was the causative agent [13]. In a second case report, a patient had no previous history of liver disease or concomitant risk factors for liver disease and developed sub acute liver failure during therapy with Adalimumab for psoriatic arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Several case reports were found detailing hepatotoxicity with Adalimumab or mesalamine monotherapy [8][9][10][11][12][13][14][15]. One such case report details a patient treated with Adalimumab for rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Several case reports were found detailing hepatotoxicity with Adalimumab or mesalamine monotherapy [8][9][10][11][12][13][14][15]. In addition to these case reports, review articles and original research articles were found detailing this adverse effect [16][17][18][19][20].…”

Section: Case Reportmentioning

confidence: 99%

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Drug Induced-Hepatotoxicity with Concurrent Use of Adalimumab and Mesalamine for the Treatment of Crohn’s Disease

Hahn¹

2015

GHOA

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Objective: To describe hepatotoxicity in a patient receiving combination therapy with Mesalamine and Adalimumab for the treatment of Crohn's disease. Discussion: Although cases of Adalimumab or Mesalamine hepatotoxicity occurring with monotherapy have been published, the reported incidence of hepatotoxicity is low. No previous cases of hepatotoxicity occurring with this combination therapy have been reported. Conclusion:Upon discontinuation of Adalimumab and Mesalamine the patient's liver function improved, leading to the conclusion of drug-induced hepatotoxicity. This case should highlight the importance of routine liver function tests in patients receiving Adalimumab and Mesalamine combination therapy, along with early recognition and medication discontinuation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Drug Induced-Hepatotoxicity with Concurrent Use of Adalimumab and Mesalamine for the Treatment of Crohn’s Disease

Hahn¹

2015

GHOA

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“…Adalimumab was also demonstrated to cause cholestatic liver injury in a patient with chronic hepatitis C virus and RA who was treated with adalimumab due to RA reactivation . At the third month of treatment, the patient began having pruritus with liver function tests showing elevations in GGT, ALP, and AST.…”

Section: Tumor Necrosis Factor Alpha Inhibitorsmentioning

confidence: 99%

“…At the third month of treatment, the patient began having pruritus with liver function tests showing elevations in GGT, ALP, and AST. A liver biopsy showed portal dystrophy, portal inflammation with eosinophils, lobular hepatitis, and microabscesses …”

Section: Tumor Necrosis Factor Alpha Inhibitorsmentioning

confidence: 99%

Biologic and Checkpoint Inhibitor‐Induced Liver Injury: A Systematic Literature Review

2020

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Biologics are among the most commonly prescribed medications for several chronic inflammatory diseases. Tumor necrosis factor alpha inhibitors, more so than other agents, have been observed to cause drug-induced liver injury. Additionally, because the approval and popularity of checkpoint inhibitors have grown, similar patterns of liver injury have been documented, with a majority of cases describing immune-mediated hepatitis. Although the exact mechanism of injury is unknown, various host and medication characteristics play a role in the outcome of the molecular cascade invoked by biologics. Prognosis is usually favorable with cessation of the offending agent, but cases of acute liver failure requiring liver transplantation have also been observed. Therefore, algorithms have been created to assist clinicians in treating drug-induced autoimmune hepatitis, mostly with corticosteroids. Additionally, case reports have documented successfully rechallenging patients with a different biologic without recurrence of liver injury, but data are limited. Further investigation is warranted regarding the potential for cross-reactivity and mechanism of injury to develop guidelines to aid clinicians in further management of these patients. (Hepatology Communications 2020;4:172-184).

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Hepatotoxicity Associated with the Use of Anti-TNF-α Agents

et al. 2015

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Medications to inhibit the actions of tumour necrosis factor alpha have revolutionized the treatment of several pro-inflammatory autoimmune conditions. Despite their many benefits, several serious side effects exist and adverse reactions do occur from these medications. While many of the medications’ potential adverse effects were anticipated and recognized in clinical trials prior to drug approval, several more rare adverse reactions were recorded in the literature as the popularity, availability and distribution of these medications grew. Of these potential adverse reactions, liver injury, although uncommon, has been observed in some patients. As case reports accrued over time and ultimately case series developed, the link became better established between this family of medicines and various patterns of liver injury. Interestingly, it appears that the majority of cases exhibit an autoimmune hepatitis profile both in serological markers of autoimmune liver disease and in classic autoimmune features seen on hepatic histopathology. Despite the growing evidence of this relationship, the pathogenesis of this reaction remains incompletely understood, but it appears to depend on characteristics of the medications and the genetic composition of the patients; it is likely more complicated than a simple medication class effect. Because of this still incomplete understanding and the infrequency of the occurrence, treatments have also been limited, although it is clear that most patients improve with cessation of the offending agent and, in certain cases, glucocorticoid use. However, more needs to be done in the future to unveil the underlying mechanisms of this adverse reaction.

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Drug-Induced Liver Injury Caused by Adalimumab: A Case Report and Review of the Bibliography

Cited by 8 publications

References 23 publications

Drug Induced-Hepatotoxicity with Concurrent Use of Adalimumab and Mesalamine for the Treatment of Crohn’s Disease

Drug Induced-Hepatotoxicity with Concurrent Use of Adalimumab and Mesalamine for the Treatment of Crohn’s Disease

Biologic and Checkpoint Inhibitor‐Induced Liver Injury: A Systematic Literature Review

Hepatotoxicity Associated with the Use of Anti-TNF-α Agents

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