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Hepatoprotective effect of TNFα blockade in psoriatic arthritis: A cross-sectional study
  1. Michael Seitz1,*,
  2. Stephan Reichenbach1,
  3. Burkhard Möller1,
  4. Marcel Zwahlen2,
  5. Peter M Villiger1,
  6. Jean-Francois Dufour3
  1. 1 Department of Rheumatology, Clinical Immunology & Alllergology, University Hospital Bern, Switzerland;
  2. 2 Institutte of Social and Preventive Medicine, University of Bern, Switzerland;
  3. 3 Institute of Clinical Pharmacology and Visceral Research, University of Bern, Switzerland
  1. 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}


Objective: To evaluate the impact of TNFα 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 TNFα 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-TNFα-naïve and in 13% of the anti-TNFα-treated patients in the RA group, and in 30% of the anti-TNFα-naïve and 4.3% of the anti-TNFα-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 TNFα inhibitors against the development of liver fibrosis in patients with PsA.

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