Parisi, I;
O'Beirne, J;
Rossi, RE;
Tsochatzis, E;
Manousou, P;
Theocharidou, E;
Hamilton, M;
... Burroughs, AK; + view all
(2016)
Elevated liver enzymes in inflammatory bowel disease: the role and safety of infliximab.
European Journal of Gastroenterology & Hepatology
, 28
(7)
pp. 786-791.
10.1097/MEG.0000000000000624.
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Abstract
BACKGROUND: Abnormal liver enzymes are frequently encountered in inflammatory bowel disease (IBD) patients. Infliximab has been implicated in inducing drug-induced liver injury, autoimmune hepatitis or reactivation of hepatitis B virus. We aimed to clarify the role of infliximab in liver impairment in an IBD cohort. STUDY: A total of 305 patients with IBD, without evidence of chronic liver disease, were included in the study and retrospectively evaluated. Laboratory and clinical data were retrieved from a prospectively acquired database. In all, 176 consecutive patients treated with infliximab during the last 5 years were compared with a matched population of 129 patients who did not receive any antitumour necrosis factor treatment. RESULTS: Elevation of alanine transaminase (ALT) was frequent in the entire population (36.4%) and it was not significantly associated with the use of infliximab (P=0.284). Elevations more than 3 upper limit of normal were observed in 7.9% and these resolved spontaneously in 83%. The use of immunomodulators was the only factor that was significantly associated with liver enzyme abnormalities in multivariate analysis [odds ratio (OR) 2.666, 95% confidence interval (CI) 1.576-4.511, P<0.005]. Overall, 39% of patients on infliximab had elevated liver enzymes and this was associated with increased ALT before starting infliximab (OR 3.854, 95% CI 1.800-8.251, P=0.001) and with longer duration of infliximab treatment (OR 1.030, 95% CI 1.013-1.047, P=0.001). CONCLUSION: Elevated liver enzymes are frequently found in IBD patients and they usually resolve spontaneously. The use of immunomodulators was independently associated with increased ALT. Infliximab is relatively safe in terms of liver impairment and discontinuation of treatment is rarely required in the setting of modest elevations of ALT.
| Type: | Article |
|---|---|
| Title: | Elevated liver enzymes in inflammatory bowel disease: the role and safety of infliximab |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/MEG.0000000000000624 |
| Publisher version: | http://doi.org/10.1097/MEG.0000000000000624 |
| Language: | English |
| Additional information: | © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is a non-final version of an article published in final form in Parisi, I; O'Beirne, J; Rossi, RE; Tsochatzis, E; Manousou, P; Theocharidou, E; Hamilton, M; (2016) Elevated liver enzymes in inflammatory bowel disease: the role and safety of infliximab. European Journal of Gastroenterology & Hepatology , 28 (7) pp. 786-791. 10.1097/MEG.0000000000000624. |
| Keywords: | Elevated liver enzymes, hepatotoxicity, inflammatory bowel disease, infliximab |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1481181 |
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