4.7 Article

Hepatoprotective effect of tumour necrosis factor alpha blockade in psoriatic arthritis: a cross-sectional study

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ANNALS OF THE RHEUMATIC DISEASES
卷 69, 期 6, 页码 1148-1150

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B M J PUBLISHING GROUP
DOI: 10.1136/ard.2009.116194

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Objective To evaluate the impact of tumour necrosis factor a (TNF alpha) blockers on the presence of liver fibrosis in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) treated with methotrexate (MTX). Methods Participants were consecutive patients with RA and PsA who had undergone MTX treatment for at least 1 year +/- TNF blockade for over 6 months. Liver fibrosis was assessed using non-invasive transient elastography (FibroScan). Regression models were used to compare FibroScan values of patients with RA and patients with PsA receiving TNF alpha blockers with those who were not. Results FibroScan assessments were performed on 51 patients with RA and 43 patients with PsA. Compared to patients with RA, those with PsA were predominantly young men, received lower cumulative dosages of MTX and exhibited a higher incidence of liver steatosis and hyperlipidaemia. An abnormal result was observed in 7.1% of the anti-TNF alpha-naive and in 13% of the anti-TNF alpha-treated patients in the RA group and in 30% of the anti-TNF alpha-naive and 4.3% of the anti-TNF alpha-treated patients in the PsA group (OR = 0.11, 95% CI 0.02 to 0.98). Results of the PsA group were robust when adjusted for baseline characteristics. Conclusion The results suggest a protective effect of TNF alpha inhibitors against the development of liver fibrosis in patients with PsA.

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