Hepatotoxicity related to antirheumatic drugs.
Antirheumatic agents are among commonly used drugs associated with adverse hepatic reactions. Sulfasalazine and azathioprine are among the most important causes of acute hepatotoxicity. Because such a large number of people take NSAIDs, even the rare occurrence of hepatotoxicity from these agents might contribute substantially to the total burden of drug-induced liver disease. A wide spectrum of hepatotoxic effects is described with antirheumatic drugs. Studies investigating genetic susceptibility to diclofenac hepatotoxicity have expanded our understanding of the potential drug-specific, class-specific and general factors involved in its pathogenesis, and methotrexate-associated liver disease demonstrates the interaction between drug, host and environmental factors that determines the likelihood and magnitude of liver disease. Infliximab therapy is associated with typical drug-induced autoimmune hepatitis. Although validated causality assessment methods have been used to objectively assess the strength of the association between a drug and a clinical event, in practice the diagnosis of drug-induced liver injury (DILI) involves a clinical index of suspicion, pattern recognition, the establishment of a temporal relationship between drug exposure and the adverse event, and the exclusion of alternative explanations for the clinical presentation. Detailed understanding of genetic and environmental factors underlying an individual's susceptibility would enable risk reduction and potentially primary prevention of hepatotoxicity.
Nottingham Digestive Diseases Centre, National Institute of Health Research Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, UK. guru.aithal@nuh.nhs.uk
Guruprasad P
GP
Aithal
D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000494:pharmacology; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology* / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008099:Liver / Q000187:drug effects; D012307:Risk Factors
D018501:Antirheumatic Agents
Ann Rheum Dis. 1990 Jan;49(1):25-7
2138007
Pharmacogenomics. 2010 Feb;11(2):163-75
20136356
Eur J Clin Pharmacol. 2008 Nov;64(11):1057-68
18607581
Arthritis Rheum. 2004 May;50(5):1370-82
15146406
Intern Emerg Med. 2010 Jun;5(3):193-200
20107930
J Rheumatol. 2008 Apr;35(4):572-9
18381794
Hepatology. 2009 Dec;50(6):1818-26
19824078
J Rheumatol. 2008 Jul;35(7):1454-7
18609744
Liver Int. 2003 Apr;23(2):89-93
12654130
Eur J Gastroenterol Hepatol. 2006 May;18(5):553-5
16607155
Epidemiology. 1993 Nov;4(6):496-501
8268277
Pharmacogenetics. 2000 Aug;10(6):511-8
10975605
Am J Clin Dermatol. 2005;6(6):357-63
16343024
Semin Cutan Med Surg. 1996 Dec;15(4):250-7
9069593
Dev Cell. 2008 Dec;15(6):795-6
19081067
Drugs. 2002;62(4):605-16
11893229
Gastroenterology. 2007 Jan;132(1):272-81
17241877
Nat Genet. 2010 Aug;42(8):650-1
20664647
Br J Dermatol. 2003 May;148(5):1035-9
12786839
J Hepatol. 2009 Oct;51(4):778-86
19664838
Hepatology. 2004 May;39(5):1430-40
15122773
Ann Rheum Dis. 1996 May;55(5):273-5
8660097
Clin Pharmacol Ther. 2004 Mar;75(3):223-33
15001974
Cancer Res. 2006 Jan 1;66(1):125-33
16397224
J Clin Epidemiol. 1993 Nov;46(11):1323-30
8229110
J Rheumatol. 2008 Mar;35(3):469-71
18085735
BMJ. 2006 Aug 19;333(7564):380-4
16916825
Am J Gastroenterol. 2009 Feb;104(2):356-62
19174782
Dig Dis Sci. 1988 Aug;33(8):1025-9
3134176
Aliment Pharmacol Ther. 2004 Feb 15;19(4):391-9
14871278
Pharmacogenomics J. 2007 Feb;7(1):56-65
16788565
Hepatology. 2005 May;41(5):976-9
15841447
Science. 2006 Aug 25;313(5790):1137-40
16931765
Arch Intern Med. 1994 Feb 14;154(3):311-6
8297198
J Hepatol. 2006 Aug;45(2):321-33
16797772
Aliment Pharmacol Ther. 2004 Aug 15;20(4):373-80
15298630
J Rheumatol. 2009 Dec;36(12):2813-8
19918032
Pharmacoepidemiol Drug Saf. 2006 Apr;15(4):213-20
16456879
Nat Rev Drug Discov. 2007 Jan;6(1):75-92
17195034
Pharmacoepidemiol Drug Saf. 2003 Jun;12(4):315-26
12812012
J Hepatol. 2010 Dec;53(6):1035-40
20801541
Br J Clin Pharmacol. 2004 Jul;58(1):71-80
15206996
Clin Pharmacol Ther. 2009 Mar;85(3):331-4
19129750
Am J Med. 2004 Jul 15;117(2):87-92
15234643
Clin Rheumatol. 2007 Apr;26(4):578-81
16547695
Drug Saf. 2009;32(12):1123-34
19916579
BMJ. 2003 Jul 5;327(7405):18-22
12842950
Hepatology. 2006 Jul;44(1):7-14
16799965
Hepatology. 1991 Sep;14(3):422-5
1908434
Hepatology. 2008 Feb;47(2):455-60
18038452
Cochrane Database Syst Rev. 2010 Apr 14;(4):CD008495
20393970
Pharmacogenetics. 2001 Oct;11(7):597-607
11668219
Hepatology. 2005 Aug;42(2):481-9
16025496
J Rheumatol. 2009 Mar;36(3):539-45
19208607
Semin Liver Dis. 2002;22(2):169-83
12016548
Gastroenterology. 2002 Apr;122(4):904-15
11910342
Ann Rheum Dis. 2010 Jan;69(1):43-7
19147616
Gastroenterology. 1999 Oct;117(4):962-71
10500080
Aliment Pharmacol Ther. 2008 Sep 15;28(6):734-41
19145729
Am J Med. 1991 Jun;90(6):711-6
1828327
Scand J Rheumatol. 1992;21(5):220-5
1359635
BMC Musculoskelet Disord. 2008 Apr 11;9:48
18405372
Clin Gastroenterol Hepatol. 2007 Feb;5(2):209-14
17296529
Rheumatology (Oxford). 2000 Jun;39(6):655-65
10888712
Expert Opin Drug Saf. 2004 Nov;3(6):519-23
15500411
Br J Dermatol. 2005 Mar;152(3):405-8
15787807
Toxicology. 2002 Dec 27;181-182:55-63
12505285
Biochem Pharmacol. 2002 Dec 1;64(11):1579-89
12429347
Hepatology. 1995 Sep;22(3):820-7
7657288
J Hepatol. 2007 Jun;46(6):995-8
17445937
Clin Pharmacol Ther. 2003 Oct;74(4):380-7
14534525
J Hepatol. 1997;26 Suppl 1:31-5
9138126
Inflamm Bowel Dis. 2007 Sep;13(9):1106-14
17455203
Ann Rheum Dis. 2010 Sep;69(9):1612-7
20448284
Liver Transpl. 2005 Jul;11(7):826-833
15973722
Nat Rev Drug Discov. 2005 Jun;4(6):489-99
15931258
Gastroenterology. 1993 Feb;104(2):569-74
8425699
Regul Toxicol Pharmacol. 2000 Aug;32(1):56-67
11029269
J Hepatol. 2007 Jun;46(6):1111-8
17399848
Nat Genet. 2010 Aug;42(8):711-4
20639878
Clin Chem. 2003 Jan;49(1):1-6
12507953
Ann Rheum Dis. 2004 Feb;63(2):123-9
14722198
Br J Dermatol. 2005 Mar;152(3):444-50
15787812
Birth Defects Res A Clin Mol Teratol. 2004 Jun;70(6):396-9
15211708
J Rheumatol. 2008 Mar;35(3):472-6
18203324
Ann N Y Acad Sci. 2010 Jan;1183:222-36
20146718
Ann Rheum Dis. 2009 Jul;68(7):1100-4
19060002
Clin Liver Dis. 2007 Aug;11(3):563-75, vi-vii
17723920