Journal Title
Title of Journal: Drug Saf
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Publisher
Springer International Publishing
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Authors: Joshua B French Maurizio Bonacini Marwan Ghabril David Foureau Herbert L Bonkovsky
Publish Date: 2015/12/21
Volume: 39, Issue: 3, Pages: 199-208
Abstract
Medications to inhibit the actions of tumour necrosis factor alpha have revolutionized the treatment of several proinflammatory 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 reactionThis work was supported by U01 cooperative agreements between the National Institutes of Health/National Institute for Diabetes and Digestive and Kidney Diseases and the University of North Carolina Chapel Hill/Wake Forest University Health Sciences DK065201 and Indiana University DK065211 by a U54 award from the National Institutes of Health/National Institute for Diabetes and Digestive and Kidney Diseases DK083909 to Wake Forest HLB PI and by a grant from the National Institutes of Health/National Heart Lung and Blood Institute R15 HL117199 to HLB
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