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Treatment of ankylosing spondylitis with TNF inhibitors does not have adverse effect on results of liver function tests: a longitudinal study
Author(s) -
Capkin Erhan,
Karkucak Murat,
Cosar Arif M.,
Ak Emel,
Karaca Adem,
Gokmen Ferhat,
Budak Bayram S.,
Tosun Mehmet
Publication year - 2015
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12311
Subject(s) - medicine , ankylosing spondylitis , adalimumab , erythrocyte sedimentation rate , basdai , etanercept , alanine transaminase , gastroenterology , aspartate transaminase , infliximab , liver function , liver function tests , adverse effect , tumor necrosis factor alpha , arthritis , psoriatic arthritis , alkaline phosphatase , biochemistry , chemistry , enzyme
Aim To retrospectively investigate and compare the effects of tumor necrosis factor alpha inhibitors ( TNF i) on hepatic enzymes in ankylosing spondylitis ( AS ) patients. Methods A retrospective analysis of the records of 94 AS (66 male, 28 female) patients using TNF i was performed. Patients' clinical data, B ath A nkylosing S pondylitis D isease A ctivity ( BASDAI ) scores, erythrocyte sedimentation rate ( ESR ) and C ‐reactive protein ( CRP ) levels were all examined. Liver function test ( LFT s) results of patients before the treatment and 3, 6 and 12 months after treatment with TNF i were investigated. Aspartate transaminase ( AST ) and alanine transaminase ( ALT ) levels were investigated as indicators of LFT s. Results The TNFi drugs used were infliximab ( n = 28), adalimumab ( n = 32) and etanercept ( n = 34). Pre‐treatment values of ESR , CRP and BASDAI scores were 28.3 ± 20.1 mm/h, 1.5 ± 1.2 ng/dL and 5.2 ± 0.8, respectively. Following TNF i use there was a statistically significant decrease in disease activity score ( P = 0.001). There was a significant increase in LFT at the third month evaluation compared to the initial values, while the average value was within normal range (baseline AST 19.6 ± 10.8 U/L, ALT 19.1 ± 6.4 U/L, third month AST 31.3 ± 21.6 U/L, ALT 28.1 ± 18.1 U/L, P = 0.001). Drug group comparison analysis revealed a significant difference in the adalimumab group value at the end of the first year, but no other significant difference in the data for the other months ( P > 0.05). No significant correlation was determined between initial disease activity scores and LFT . Conclusion TNFi use‐associated rises in hepatic enzymes were determined compared to pre‐treatment but the mean values remained within normal limits. Considering the cases in the literature, in daily practice patients must be carefully monitored for liver function before treatment and at follow‐up.