High prevalence of non-alcoholic fatty liver disease in patients with inflammatory bowel disease receiving anti-tumor necrosis factor therapy

Likhitsup, Alisa; Dundulis, Jason; Ansari, Shaya; Patibandla, Sruthi; Hutton, Colleen; Kennedy, Kevin F.; Helzberg, John H.; Chhabra, Rajiv

doi:10.20524/aog.2019.0405

Cited by 17 publications

(44 citation statements)

References 40 publications

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“…The evidence that anti-TNFα drugs may reduce MTX-induced hepatotoxicity is potentially of great clinical interest because these drugs are often associated with MTX to potentiate immunosuppressant activity. Clinical study will be necessary to substantiate the potential beneficial effect of combining these drugs in humans, also considering that a note of caution derives from published (though controversial) data suggesting that anti-TNFα agents themselves could be hepatotoxic [ 112 , 113 ]. Nonetheless, the preclinical evidence we reviewed provides an elegant example of the concept that DISH could be prevented by choosing appropriate drug combinations that also give definite advantages for the primary goal of the therapy.…”

Section: Methotrexate: If You Cannot Make It By Yourself Ask a Friend For Helpmentioning

confidence: 99%

New Avenues for Treatment and Prevention of Drug-Induced Steatosis and Steatohepatitis: Much More Than Antioxidants

et al. 2021

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Drug-induced lipid accumulation in the liver may induce two clinically relevant conditions, drug-induced steatosis (DIS) and drug-induced steatohepatitis (DISH). The list of drugs that may cause DIS or DISH is long and heterogeneous and includes therapeutically relevant molecules that cannot be easily replaced by less hepatotoxic medicines, therefore making specific strategies necessary for DIS/DISH prevention or treatment. For years, the only available tools to achieve these goals have been antioxidant drugs and free radical scavengers, which counteract drug-induced mitochondrial dysfunction but, unfortunately, have only limited efficacy. In the present review we illustrate how in vitro preclinical research unraveled new key players in the pathogenesis of specific forms of DISH, and how, in a few cases, proof of

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Section: Methotrexate: If You Cannot Make It By Yourself Ask a Friend For Helpmentioning

confidence: 99%

New Avenues for Treatment and Prevention of Drug-Induced Steatosis and Steatohepatitis: Much More Than Antioxidants

et al. 2021

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“…In IBD patients, hypertension, obesity, small bowel surgery, and use of corticosteroids at the time of imaging were associated with NAFLD, while among patients receiving anti-TNFα therapy, NAFLD has been shown to be less prevalent[ 10 ]. In contrast, another study found a high prevalence of NAFLD among IBD patients under anti-TNFα treatment[ 11 ].…”

Section: Introductionmentioning

confidence: 98%

Prevalence and risk factors of nonalcoholic fatty liver disease in patients with inflammatory bowel diseases: A cross-sectional and longitudinal analysis

Hoffmann

Jung

Behnisch

et al. 2020

WJG

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BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is common in the German population, with an even higher prevalence in inflammatory bowel disease patients. AIM To investigate the risk factors for NAFLD in inflammatory bowel disease patients. METHODS This monocentric retrospective study with a cross-sectional and a longitudinal part included 694 patients. Inclusion criteria were diagnosed inflammatory bowel disease, age ≥ 18 years, availability of at least one abdominal ultrasound. Patients with infectious or suspected alcoholic fatty liver disease were excluded. NAFLD was defined by increased echogenicity at liver ultrasound. Demographic characteristics, disease activity and medications were analyzed as potential risk factors. Parameters influencing the course of NAFLD were identified by a generalized linear mixed model. RESULTS Forty-eight percent of Crohn’s disease (CD) patients and 44% of ulcerative colitis patients suffered from NAFLD. Its occurrence was associated with greater age, hypertension and body mass index (BMI) in both groups, and with higher disease activity and dyslipidemia in CD. 2467 ultrasound results were included in the longitudinal analysis. Risk factors for NAFLD were age, BMI, higher disease activity, bowel resection(s), endoscopic activity and azathioprine use in CD; and BMI and endoscopic activity in ulcerative colitis. CONCLUSION NAFLD was highly prevalent in this cohort of German inflammatory bowel disease patients. Its risk increased mainly with rising age and BMI. This analysis provides a rationale for non-invasive liver screening in inflammatory bowel disease patients.

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“…A recent study identified a high prevalence of steatosis and NAFLD among patients with IBD receiving anti-TNF therapy. 5 However, a metaanalysis has not described any association between medication used in treating CD and the risk of developing steatosis/NAFLD. 6 The pathophysiological processes that are involved in the development of steatosis in CD are not entirely understood.…”

Section: Introductionmentioning

confidence: 99%

Anti‐TNFα treatment in Crohn’s disease: Impact on hepatic steatosis, gut‐derived hormones and metabolic status

Manka

Sydor

Wase

et al. 2021

Liver International

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Background and Aims An association between Crohn's disease (CD) and hepatic steatosis has been reported. However, the underlying mechanisms of steatosis progression in CD are not clear. Among the most effective CD treatments are agents that inhibit Tumor‐Necrosis‐Factor (TNF) activity, yet it is unclear why anti‐TNFα agents would affect steatosis in CD. Recent studies suggest that microbiome can affect both, CD and steatosis pathogenesis. Therefore, we here analysed a potential relationship between anti‐TNF treatment and hepatic steatosis in CD, focusing on the gut‐liver axis. Methods This cross‐sectional study evaluated patients with established CD, with and without anti‐TNFα treatment, analysing serum markers of liver injury, measurement of transient elastography, controlled attenuation parameter (CAP) and MRI for fat detection. Changes in lipid and metabolic profiles were assessed by serum and stool lipidomics and metabolimics. Additionally, we analysed gut microbiota composition and mediators of bile acid (BA) signalling via stool and serum analysis. Results Patients on anti‐TNFα treatment had less hepatic steatosis as assessed by CAP and MRI. Serum FGF19 levels were significantly higher in patients on anti‐TNFα therapy and associate with reduced steatosis and increased bowel motility. Neutral lipids including triglycerides were reduced in the serum of patients on anti‐TNF treatment. Bacteria involved in BA metabolism and FGF19 regulation, including Firmicutes, showed group‐specific alterations with low levels in patients without anti‐TNFα treatment. Low abundance of Firmicutes was associated with higher triglyceride levels. Conclusions Anti‐TNFα treatment is associated with reduced steatosis, lower triglyceride levels, alterations in FXR‐signalling (eg FGF19) and microbiota composition in CD.

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High prevalence of non-alcoholic fatty liver disease in patients with inflammatory bowel disease receiving anti-tumor necrosis factor therapy

Cited by 17 publications

References 40 publications

New Avenues for Treatment and Prevention of Drug-Induced Steatosis and Steatohepatitis: Much More Than Antioxidants

New Avenues for Treatment and Prevention of Drug-Induced Steatosis and Steatohepatitis: Much More Than Antioxidants

Prevalence and risk factors of nonalcoholic fatty liver disease in patients with inflammatory bowel diseases: A cross-sectional and longitudinal analysis

Anti‐TNFα treatment in Crohn’s disease: Impact on hepatic steatosis, gut‐derived hormones and metabolic status

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