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Rheumatoid arthritis therapy and liver disease


Authors: K. Mintálová
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 31, 2023, No. 4, p. 183-189.
Category: Review Article

Overview

In recent years, we have observed an increase in liver diseases worldwide, most often in the sense of transient elevation of liver enzymes and non-alcoholic steatohepatitis (NAFLD) or non-alcoholic steatohepatitis (NASH). Most of the drugs used in the therapy of rheumatoid arthritis are potentially hepatotoxic (nonsteroidal anti-inflammatory drugs, methotrexate, leflunomide, sulfasalazine, and TNF inhibitors), so it is necessary to take into account possible pre-existing liver disease before and during antirheumatic therapy. Type 2 diabetes mellitus and obesity, which are also increasingly common, contribute to liver damage. The cytokines interleukin 6 and TNF play an important role here. In this review article, we discuss the treatment options for rheumatoid arthritis in relation to possible drug-induced liver damage.

Keywords:

NASH – liver injury – drug toxicity – hepatotoxicity – NAFLD


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