A new study published in the journal Clinical Gastroenterology and Hepatology reveals that regular use of a class of biologic response modifying drugs can increase the risk of acute liver injury with elevated liver enzymes. Patients with inflammatory diseases such as Chron's disease or ulcerative colitis often are prescribed tumor necrosis factor-alpha (TNF-α) antagonists, which modify the body's response to infection. Patients with inflammatory arthropathies and selected dermatological diseases are also candidates to receive such compounds. "TNF-α antagonists are extremely beneficial as therapies for several bowel, joint and skin inflammatory conditions," said Maurizio Bonacini, MD, AGAF, study author and associate clinical professor, University of California, San Francisco. "However, gastroenterologists, internists, rheumatologists and dermatologists all need to be aware of this potential complication and know how to diagnose it. They should conduct tests for autoimmunity early upon diagnosis of abnormalities to determine the proper path of care." Researchers searched the U.S. Drug-Induced Liver Injury Network database and identified six well-characterized cases of drug-induced liver injury (DILI) in the setting of TNF-α antagonist therapy. Additionally, they reviewed 28 additional cases identified in PubMed. The researchers found acute liver injury in all cases, most frequently autoimmunity and hepatocellular injury, but mixed non-autoimmune patterns and cholestasis (blocked flow of bile from the liver) also occurred. No deaths were attributed to the liver injury; one patient required a liver transplant, which was attributed to pre-existing cirrhosis with superimposed DILI. Of the TNF-α antagonists, infliximab-associated liver injury has been the best documented, most likely because of its earlier approval and more wide-spread clinical use. Etanercept and adalimumab have also been linked to drug-induced liver injury. So far, there are no published cases found to be linked to natalizumab, golimumab or certolizumab. The researchers found that liver damage was typically resolved following drug discontinuation, although some patients did benefit from a course of corticosteroids. Importantly, patients treated with an alternative TNF-α after resolution of their liver injury appeared to tolerate the drugs without recurrence. "If patients who are taking these biologic agents experience symptoms such as abdominal pain, nausea and fatigue, physicians should check liver enzyme levels to determine if the symptoms are a result of these drugs," added Dr. Bonacini.Source: Eurekalert << Tightness of Delivery Organ can Release Sperm Cells Smoking Ban in Schools can Reduce Number of Future Smokers >> Recommended Reading Alcoholic Liver Disease Encyclopedia section of medindia gives general information about Alcoholic Liver Disease. READ MORE Pregnancy Exercises Every pregnant woman should be aware about the basic needs of her body during the time of pregnancy. Proactive physical therapist consult is a must for healthy pregnancy. READ MORE Athletes Foot Athlete’s foot (tinea pedis/ringworm of the foot) is a fungal infection of the feet. READ MORE Current Treatments for Liver Cancer Current Treatments for Liver Cancer (also known as hepatoma or hepatocellular carcinoma) can result in complete cure of the disease if it is detected early. READ MORE Fatty Liver Disease: A Growing Health Problem in India Non alcoholic fatty liver disease (NAFLD) is the leading cause of liver dysfunction worldwide and is a rapidly growing health problem in India. READ MORE Hepatitis A Hepatitis A is the most benign of the hepatitis viruses and usually has no long term side effects. Hepatitis A vaccine is available that is 95% effective in preventing the disease. READ MORE Living Donor Liver Transplant: What Are the Risks? The risk of dying as a result of a living donor liver segment removal is between 0.2-2.0%. The risk of morbidity is anywhere between 1.3% (in highly experienced centers) to 60%. READ MORE Milk Thistle Milk Thistle is a resourceful natural plant which has many medicinal benefits. In herbal medication milk thistle is used in cases of liver diseases. READ MORE Wilson's Disease This is a rare inherited systemic disorder of copper metabolism, affecting the liver mainly before other organs. READ MORE Most Popular on Medindia Sinopril (2mg) (Lacidipine) Selfie Addiction Calculator Blood Pressure Calculator More News on: Athletes FootHepatitis ALiverWilson's DiseaseMilk ThistleCurrent Treatments for Liver CancerFatty Liver Disease: A Growing Health Problem in IndiaLiving Donor Liver Transplant: What Are the Risks?