Concise report

Hepatoprotective effect of TNF blockade in psoriatic arthritis: A cross-sectional study

Michael Seitz^1,*, Stephan Reichenbach¹, Burkhard Möller¹, Marcel Zwahlen², Peter M Villiger¹, Jean-Francois Dufour³

¹ Department of Rheumatology, Clinical Immunology & Alllergology, University Hospital Bern, Switzerland;
² Institutte of Social and Preventive Medicine, University of Bern, Switzerland;
³ Institute of Clinical Pharmacology and Visceral Research, University of Bern, Switzerland

Correspondence to: Michael N Seitz, Department of Rheumatology and Clinical Immun, University Hospital Berne, Switzerland, University Hospital, Inselspital, Department of Rheumatology and Clinical Immunology/Allergology, Berne, 3010, Switzerland; michael.seitz{at}insel.ch

Accepted 3 October 2009

Objective: To evaluate the impact of TNF blockers on the presence of liver fibrosis in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) treated with methotrexate (MTX).

Methods: Subjects were consecutive patients with RA and PsA who had undergone MTX treatment for at least one year +/- TNF blockade for over 6 months. Liver fibrosis was assessed using non-invasive transient elastography (FibroScan). Regression models were used to compare FibroScan values of RA and PsA patients receiving TNF blockers with those who were not.

Results: FibroScan assessments were performed on 51 RA and 43 PsA patients. Compared to RA patients, those with PsA were predominantly young males, received lower cumulative dosages of MTX and exhibited a higher incidence of liver steatosis and hyperlipidemia. An abnormal result was observed in 7.1% of the anti-TNF-naïve and in 13% of the anti-TNF-treated patients in the RA group, and in 30% of the anti-TNF-naïve and 4.3% of the anti-TNF-treated patients in the PsA group (OR = 0.11, 95% CI 0.02 to 0.98). Results of the PsA group were robust when adjusted for baseline characteristics.

Conclusion: The results suggest a protective effect of TNF inhibitors against the development of liver fibrosis in patients with PsA.

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