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Rheumatoid arthritis (RA) is a systemic disease, with extra-articular manifestations,1 including inflammatory liver disease.2 ,3 Our recent results indicate that elevated transaminase levels in RA patients on methotrexate (MTX) are rarely related to MTX-specific liver lesions (5%), but frequently to autoimmune hepatitis (AIH) histological lesions (41%).2 ,4 We have previously found that inhibition of tumour necrosis factor (TNF) with etanercept was well tolerated in patients with arthritis and hepatitis C virus infection.5 Since TNFα inhibition can control RA joint disease, we asked the question of a possible positive effect of TNFα inhibitors on RA-associated liver disease.
The objective of this proof of concept study was to evaluate the effect of 6 months of etanercept treatment on RA-associated AIH histological lesions.
Among a population of 1571 patients treated with MTX for chronic arthritis, 53 with persistent abnormal …
Footnotes
Contributors GT enrolled the patients, collected the results and wrote the report. J-YS read the biopsies and collected the results. PM enrolled the patients and wrote the report.
Competing interests None.
Ethics approval Approval provided by the Ethical committee of the hospital of Lyon.
Provenance and peer review Not commissioned; externally peer reviewed.