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

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• 作者：Joshua B. French ; Maurizio Bonacini ; Marwan Ghabril ; David Foureau…
• 刊名：Drug Safety
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：39
• 期：3
• 页码：199-208
• 全文大小：735 KB
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• 作者单位：Joshua B. French (1)
  Maurizio Bonacini (2)
  Marwan Ghabril (3)
  David Foureau (4)
  Herbert L. Bonkovsky (1) (5) (6)
  
  1. Section on Gastroenterology and Hepatology, Department of Internal Medicine, Wake Forest Health Sciences, Winston-Salem, NC, USA
  2. Liver Center, Sutter Health, San Francisco, CA, USA
  3. Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Suite 225, 702 Rotary Circle, Indianapolis, IN, USA
  4. Department of Research, Carolinas HealthCare System, Charlotte, NC, USA
  5. Department of Medicine, University of Connecticut Health Science Center, Farmington, CT, USA
  6. Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
  
• 刊物主题：Drug Safety and Pharmacovigilance; Pharmacology/Toxicology;
• 出版者：Springer International Publishing
• ISSN：1179-1942

文摘

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.