Table 4

Relationship between increased liver function tests and tumour necrosis factor inhibitor (TNF-I) use

Model 1Model 2Model 3
ALT and/or AST >1× ULN
Main effects model
 Adalimumab (ADA)1.35 (1.09 to 1.66)*1.44 (1.13 to 1.83)*1.29 (0.99 to 1.67)
 Etanercept (ETN)1.00 (0.83 to 1.21)0.99 (0.79 to 1.25)0.95 (0.71 to 1.28)
 Infliximab (INF)1.58 (1.35 to 1.86)*1.36 (1.13 to 1.65)*1.69 (1.34 to 2.13)*
Interaction model
ADA + MTX1.45 (1.14 to 1.85)*1.41 (1.05 to 1.90)*
ETN + MTX1.00 (0.80 to 1.26)1.11 (0.80 to 1.55)
INF + MTX1.37 (1.13 to 1.66)*1.27 (0.94 to 1.70)
ADA (no MTX)1.21 (0.80 to 1.84)1.01 (0.59 to 1.74)
ETN (no MTX)1.08 (0.77 to 1.52)0.67 (0.37 to 1.22)
INF (no MTX)2.42 (1.76 to 3.34)*3.12 (2.10 to 4.65)*
ALT and/or AST >2× ULN
Main effects model
 ADA1.72 (0.99 to 3.01)1.81 (0.88 to 3.76)2.32 (1.29 to 4.18)*
 ETN1.10 (0.64 to 1.88)1.06 (0.50 to 2.27)0.68 (0.27 to 1.76)
 INF2.40 (1.53 to 3.76)*2.38 (1.37 to 4.15)*2.47 (1.36 to 4.47)*
  • Results listed as adjusted ORs with 95% CI.

  • Reference group is patients on other non-biological disease-modifying antirheumatic agents (DMARDs) except in model 2. Model 1 includes prevalent TNF-I users in patients on MTX, LEF and other non-biological DMARDs; model 2 is compared with MTX use alone; model 3 includes incident TNF-I users on MTX, LEF and other non-biological DMARDs.

  • * p<0.05.

  • ALT, alanine aminotransferase; AST, aspartate aminotransferase; LEF, leflunomide; MTX, methotrexate; ULN, upper limit of normal.