Hepatotoxicty of Agents Used in the Management of Inflammatory Bowel Disease: a 2020 Update

Barnhill, Michele; Steinberg, Joshua M.; Jennings, Joseph; Lewis, James H.

doi:10.1007/s11894-020-00781-3

Cited by 12 publications

(15 citation statements)

References 83 publications

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“…En las alteraciones de la bioquímica hepatica, además de considerar enfermedades autoinmunes concomitantes, se debe descartar hepatotoxicidad relacionada al tratamiento, cuando reciben azatioprina o antagonistas del factor de necrosis tumoral alfa 16 . En relación con la hepatitis autoinmune, es importante tomar en cuenta que las recaídas después de suspender las tiopurinas son del 25-100%, con mayor riesgo en pacientes con otras IMID.…”

Section: Discussionunclassified

Colitis ulcerosa cr�nica idiop�tica, la inflamaci�n m�s all� del intestino: presentaci�n de un caso cl�nico

Miranda-Cordero¹

2021

IMIDS

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Las enfermedades inflamatorias inmunomediadas (IMID, por sus siglas en inglés) son enfermedades crónicas, multifactoriales, que se caracterizan por alteraciones en la homeostasis celular. Cuando se presentan, existe un mayor riesgo de desarrollar una segunda IMID. En la enfermedad inflamatoria intestinal se estima una prevalencia del 26.6% de otras IMID. Aún no están claros los diferentes mecanismos asociados entre las diferentes IMID; sin embargo, el abordaje multidisciplinario permite un mejor control del proceso autoinmune subyacente, particularmente cuando el tratamiento impacta las vías involucradas en la fisiopatología. A continuación, se describe el caso de una mujer que presenta vitíligo, síndrome de Sjögren, artritis reumatoide y hepatitis autoinmune, complicada con colitis ulcerosa, 10 años después del inicio de la artritis reumatoide.

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Section: Discussionunclassified

Colitis ulcerosa cr�nica idiop�tica, la inflamaci�n m�s all� del intestino: presentaci�n de un caso cl�nico

Miranda-Cordero¹

2021

IMIDS

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“…Liver damage has been reported more frequently in patients with high body mass index, hepatic steatosis, and longer disease duration, 7 but not all studies have confirmed those findings. 8 Although Infliximab-induced DILI seems to be relatively rare in IBD patients, it is often reported in the rheumatology literature, probably mirroring the use of the drugs, as rheumatological patients are the most common type of patients treated. The reported serologic and pathologic characteristics are similar to idiopathic AIH, and liver injury resolves in most patients following infliximab withdrawal.…”

Section: Dili Induced By Tnf-α Blocking Agentsmentioning

confidence: 99%

Hepatotoxicity Induced by Biological Agents: Clinical Features and Current Controversies

Hernández¹,

Bessone²

2022

J Clin Transl Hepatol

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Novel biological agents including cytokines and recombinant fusion proteins are increasingly prescribed for cancer, rheumatologic, autoimmune, and inflammatory diseases, and are currently being evaluated in hepatocellular carcinoma (HCC). They are classified by their mechanism of action and include tumor necrosis factor-alpha (TNF-α) antagonists, T cell mediated antitumor inhibitors, interleukin receptor antagonists, and immune checkpoint inhibitors (ICIs). Some ICIs cause frequent hepatotoxicity with a variable clinical, biochemical, and serological presentation, especially in patients receiving another immunomodulatory agent. Half of the cases of liver damage induced by biological agents spontaneously regress after drug withdrawal, but the others require steroid therapy. Unfortunately, there are no widely accepted recommendation for the use of corticosteroids in these patients, even though international cancer societies have their own guidelines. Differentiating drug-induced autoimmune hepatitis (DIAIH) from classic AIH is challenging for pathologists, but liver biopsy is valuable, particularly in cases with unclear clinical presentation. Interesting, novel histological patterns have been described in liver damage induced by these agents (i.e., endothelitis, ring granuloma and secundary sclerosing cholangitis associated with lymphocytic infiltration of cytotoxic CD8+T cells). Here, we describe the clinical and biochemical characteristics of patients with hepatotoxicity induced by TNF-α antagonists and ICIs. Controversial issues involved in the administration of corticosteroid therapy, and hepatitis B virus (HBV) reactivation induced by immunosuppressive therapy are also discussed.

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“…Sphingosine 1-phosphate receptors: Ozanimod a small molecule selective agonist against phosphate-1-sphingosine type 1 and 5 receptors that prevents lymphocyte trafficking to the intestine has recently been approved for moderate-to-severe active UC[ 105 ]. The increase in GGT was seen in 5.3% of the patients[ 106 ].…”

Section: Dili In the Management Of Ibdmentioning

confidence: 99%

Hepatobiliar manifestations in inflammatory bowel disease: A practical approach

Núñez¹,

Castro²,

Mezzano³

et al. 2022

WJH

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Inflammatory bowel diseases (IBD) are associated with various hepatobiliary disorders. They can occur at any moment in the course of the disease or associated with the treatment. The prevalence of liver dysfunction can reach up to 50% in different studies. Nonalcoholic fatty liver disease is considered the most common hepatobiliary complication in IBD, while primary sclerosing cholangitis is the most specific. Management of hepatic manifestations in IBD involves a multidisciplinary approach that includes a high index of suspicion and joint management with hepatologists. The medical confrontation with abnormal liver tests must include an exhaustive study to determine if these patterns can be related to IBD, associated diseases or to the therapies used.

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Hepatotoxicty of Agents Used in the Management of Inflammatory Bowel Disease: a 2020 Update

Cited by 12 publications

References 83 publications

Colitis ulcerosa cr�nica idiop�tica, la inflamaci�n m�s all� del intestino: presentaci�n de un caso cl�nico

Colitis ulcerosa cr�nica idiop�tica, la inflamaci�n m�s all� del intestino: presentaci�n de un caso cl�nico

Hepatotoxicity Induced by Biological Agents: Clinical Features and Current Controversies

Hepatobiliar manifestations in inflammatory bowel disease: A practical approach

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