Prevalence and risk factors for drug-induced liver injury among patients with rheumatic diseases treated with biological therapy: a single-center experience.

摘要

Drug-induced liver injury (DILI) is a common event in patientswith rheumatic diseases (RD) on biological therapy (BT). Weaimed at evaluating the prevalence and pattern of DILI.Consecutive RD patients treated with BT were followed for6 months. ALT and ALP the upper limit normal (ULN) and 3xULN injury Grade 2.582 liver function tests (LFTs) in 199 patients were evaluated,median age 53y, 59.3 % females, RA in 108, AS 49, and PsA42 patients. ALT Grade 1 elevation was observed in 25.6 %,transient in 18.6 %, persisting in 7 %, Grade 2 in 1.5 %, ALPGrade 1 in 3.5 %, transient in 2 %, persisting in 1.5 %. Wereport no case of ALP Grade 2 or Hy′s law (ALT3xULN,bilirubin2xULN). Patients with persisting ALT elevation hadhigher BMI (28.23 vs. 25.74, p=0.016), lower DAS28 (2.22 vs.5.28, p=0.046). ALT Grade 1 injury was more frequent with solotocilizumab compared with other agents (27.5 % vs. 13.6 %,p=0.01). DILI was frequent, in 18.6 % transient, in 7 %persisting, Grade 2 in 1.5 %, led to treatment alteration in0.5 %, with higher prevalence on solo tocilizumab therapy. Wereport no new safety signals for BT in RD.