EN PL
REVIEW PAPER
 
KEYWORDS
TOPICS
ABSTRACT
The presence of chronic liver diseases such as metabolic dysfunction-associated steatosis liver disease, viral hepatitis, and cirrhosis may affect the treatment plan in patients with rheumatologic disorders, with concern about the adverse effects of the rheumatic medications on the course of liver disease. Advanced liver disease can change the elimination and activation of many drugs. In addition, there are concerns about the risk of viral reactivation after using biologics and immunosuppressants in patients with chronic viral hepatitis. This narrative review will assess the considera­tions that should be made before starting the most frequently used drugs in all common rheumatic diseases and patients with chronic liver diseases including chronic viral hepatitis.
 
REFERENCES (72)
1.
Imran S, Thabah MM, Azharudeen M, et al. Liver abnormalities in systemic lupus erythematosus: a prospective observational study. Cureus 2021; 13: e15691, DOI: 10.7759/cureus.15691.
 
2.
Lau G, Yu ML, Wong G, et al. APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy. Hepatol Int 2021; 15: 1031–1048, DOI: 10.1007/s12072-021-10239-x.
 
3.
De Pauli S, Grando M, Miotti G, Zeppieri M. Hepatitis B virus reactivation in patients treated with monoclonal antibodies. World J Virol 2024; 13: 88487, DOI: 10.5501/wjv.v13.i1.88487.
 
4.
Hatami B, Ashtari S, Sharifian A, et al. Changing the cause of liver cirrhosis from hepatitis B virus to fatty liver in Iranian patients. Gastroenterol Hepatol Bed Bench 2017; 10 (Suppl 1): S20–S26.
 
5.
Zhai M, Long J, Liu S, et al. The burden of liver cirrhosis and underlying etiologies: results from the global burden of disease study 2017. Aging (Albany NY) 2021; 13: 279–300, DOI: 10.18632/aging.104127.
 
6.
Verhoeven F, Weil-Verhoeven D, Prati C, et al. Safety of TNF inhibitors in rheumatic disease in case of NAFLD and cirrhosis. Semin Arthritis Rheum 2020; 50: 544–548, DOI: 10.1016/ j.semarthrit.2020.03.013.
 
7.
El-Khateeb E, Darwich AS, Achour B, et al. Review article: time to revisit Child-Pugh score as the basis for predicting drug clearance in hepatic impairment. Aliment Pharmacol Ther 2021; 54: 388–401, DOI: 10.1111/apt.16489.
 
8.
West S, Kolfenbach J. Rheumatology Secrets E-Book. Elsevier, Philadelphia 2020.
 
9.
Schuppan D, Afdhal NH. Liver cirrhosis. Lancet 2008; 371: 838–851, DOI: 10.1016/S0140-6736(08)60383-9.
 
10.
Firestein GS, Budd RC, Gabriel SE, et al. Firestein & Kelley’s Textbook of Rheumatology. Elsevier Health Sciences, Philadelphia 2020.
 
11.
Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken) 2021; 73: 924–939, DOI: 10.1002/acr.24596.
 
12.
Anvari S, Tsoi K. Hepatitis B Virus reactivation with immunosuppression: a hidden threat? J Clin Med 2024; 13: 393, DOI: 10.3390/jcm13020393.
 
13.
Zhou Q, Zhang Q, Wang K, et al. Anti-rheumatic drug-induced hepatitis B virus reactivation and preventive strategies for hepatocellular carcinoma. Pharmacol Res 2022; 178: 106181, DOI: 10.1016/j.phrs.2022.106181.
 
14.
Wu YL, Ke J, Zhang BY, Zhao D. Hepatitis B virus reactivation in rheumatoid arthritis. World J Clin Cases 2022; 10: 12–22, DOI: 10.12998/wjcc.v10.i1.12.
 
15.
Tang KT, Hung WT, Chen YH, et al. Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis B. Sci Rep 2016; 6: 22387, DOI: 10.1038/srep22387.
 
16.
Piaserico S, Messina F, Russo FP. Managing psoriasis in patients with HBV or HCV infection: practical considerations. Am J Clin Dermatol 2019; 20: 829–845, DOI: 10.1007/s40257-019- 00457-3.
 
17.
Ming-Xu H, Chen M, Cai Y, Yan-Jia H. Clinical outcomes of low-dose leflunomide for rheumatoid arthritis complicated with Hepatitis B virus carriage and safety observation. Pak J Med Sci 2015; 31: 320–324, DOI: 10.12669/pjms.312.6673.
 
18.
Wong GL, Wong VW, Thompson A, et al. Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement. Lancet Gastroenterol Hepatol 2020; 5: 776–787, DOI: 10.1016/S2468-1253(20)30190-4.
 
19.
Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken) 2016; 68: 1–25, DOI: 10.1002/acr.22783.
 
20.
Lewis JH, Stine JG. Review article: prescribing medications in patients with cirrhosis – a practical guide. Aliment Pharmacol Ther 2013; 37: 1132-1156, DOI: 10.1111/apt.12324.
 
21.
Akashi K, Saegusa J, Nakamachi Y, et al. Hepatitis B Virus Reactivation Following Salazosulfapyridine Monotherapy in a Patient with Rheumatoid Arthritis. Intern Med 2016; 55: 1371–1373, DOI: 10.2169/internalmedicine.55.5425.
 
22.
Petrov AV. Otsenka gepatotoksichnosti sul’fasalazina i gidro­ksikhlorokhina u bol’nykh revmatoidnym artritom s izolirovannym nositel’stvom HBs-antigena [Assessment of sulfasalazine and hydroxichloroqine hepatotoxicity in patients with rheumatic arthritis and isolated HBS-antigen positivity]. Lik Sprava 2004; 1: 60–65 [Article in Russian].
 
23.
Begon E, Beneton N, Poiraud C, et al. Safety and efficacy of biological therapies in patients with psoriasis with alcoholic cirrhosis: a French retrospective study of 23 cases. Br J Dermatol 2018; 179: 512–513, DOI: 10.1111/bjd.16490.
 
24.
Teixeira L, Fonseca C, Sousa S, et al. Safety of etanercept in the treatment of rheumatic disease patients with hepatitis C virus infection. Acta Reumatol Port 2018; 43: 159–160.
 
25.
Lin KM, Cheng TT, Lin JC, Chen CJ. Tumor necrosis factor- antagonist therapy for concomitant rheumatoid arthritis and hepatitis C virus infection: a case series study. Clin Rheumatol 2015; 34: 1039–1046, DOI: 10.1007/s10067-015-2962-6.
 
26.
Chen YM, Huang WN, Liao TL, et al. Comparisons of hepatitis C viral replication in patients with rheumatoid arthritis receiving tocilizumab, abatacept and tofacitinib therapy. Ann Rheum Dis 2019; 78: 849–850, DOI: 10.1136/annrheumdis- 2018-214400.
 
27.
Sargin B, Gürer G. Rituximab treatment in a patient with primary biliary cirrhosis and rheumatoid arthritis. Arch Rheumatol 2016; 31: 384–385, DOI: 10.5606/ArchRheumatol.2016.5870.
 
28.
Riveiro-Barciela M, Barreira-Díaz A, Esteban P, et al. Rituximab is a safe and effective alternative treatment for patients with autoimmune hepatitis: results from the ColHai registry. Liver Int 2024, DOI: 10.1111/liv.15970.
 
29.
Song Z, Ma Y, Jiang D, et al. Long-term safety of rituximab in DLBCL patients with hepatitis B-related cirrhosis: a retrospective case series. Front Med (Lausanne) 2022; 9: 890339, DOI: 10.3389/fmed.2022.890339.
 
30.
Roccatello D, Fenoglio R, Sciascia S. The dilemma of treating hepa­titis C virus-associated cryoglobulinemia. Curr Opin Rheumatol 2019; 31: 499–504, DOI: 10.1097/BOR.0000000000000624.
 
31.
Mauro E, Passadore P, Quartuccio L, et al. Rituximab as second- line therapy after new direct antiviral agents in peripheral neuropathy hepatitis C virus related: always correct therapeutic approach? Acta Gastroenterol Belg 2020; 83: 672–673.
 
32.
Kubodera A, Kume A, Hayashi K, et al. Immune thrombocytopenic purpura complicated by hepatitis C virus-related membranoproliferative glomerulonephritis after rituximab therapy. Intern Med 2021; 60: 2469–2473, DOI: 10.2169/ internalmedicine.6758-20.
 
33.
Sagnelli E, Pisaturo M, Sagnelli C, Coppola N. Rituximab-based treatment, HCV replication, and hepatic flares. Clin Dev Immunol 2012; 2012: 945950, DOI: 10.1155/2012/945950.
 
34.
Ennishi D, Terui Y, Yokoyama M, et al. Monitoring serum hepatitis C virus (HCV) RNA in patients with HCV-infected CD20-positive B-cell lymphoma undergoing rituximab combination chemotherapy. Am J Hematol 2008; 83: 59–62, DOI: 10.1002/ajh.21022.
 
35.
Sonneveld MJ, Murad SD, van der Eijk AA, de Man RA. Fulminant liver failure due to hepatitis B reactivation during treatment with tocilizumab. ACG Case Rep J 2019; 6: e00243, DOI: 10.14309/crj.0000000000000243.
 
36.
Campbell C, Andersson MI, Ansari MA, et al. Risk of reactivation of hepatitis B virus (HBV) and tuberculosis (TB) and complications of hepatitis C virus (HCV) following tocilizu­mab therapy: a systematic review to inform risk assessment in the COVID-19 era. Front Med (Lausanne) 2021; 8: 706482, DOI: 10.3389/fmed.2021.706482.
 
37.
Kuo MH, Tseng CW, Lu MC, et al. Risk of hepatitis B virus reactivation in rheumatoid arthritis patients undergoing tocilizumab-containing treatment. Dig Dis Sci 2021; 66: 4026–4034, DOI: 10.1007/s10620-020-06725-1.
 
38.
Ko PH, Kuo MH, Kao IT, et al. The risk of hepatitis B virus reactivation in rheumatoid arthritis patients receiving tocilizumab: a systematic review and meta-analysis. Viruses 2024; 16: 78, DOI: 10.3390/v16010078.
 
39.
Forestier E, Pasquali JL. Long-term safety of tocilizumab treatment on chronic active hepatitis C in a patient with adult onset Still’s disease. Joint Bone Spine 2015; 82: 136–137, DOI: 10.1016/j.jbspin.2014.03.010.
 
40.
Trueman S, Mohamed MF, Feng T, et al. Characterization of the effect of hepatic impairment on upadacitinib pharmacokinetics. J Clin Pharmacol 2019; 59: 1188–1194, DOI: 10.1002/jcph.1414.
 
41.
Wang ST, Tseng CW, Hsu CW, et al. Reactivation of hepati- tis B virus infection in patients with rheumatoid arthritis receiving tofacitinib. Int J Rheum Dis 2021; 24: 1362–1369, DOI: 10.1111/1756-185X.14217.
 
42.
Harigai M, Winthrop K, Takeuchi T, et al. Evaluation of hepa­titis B virus in clinical trials of baricitinib in rheumatoid arthritis. RMD Open 2020; 6: e001095, DOI: 10.1136/rmdopen- 2019-001095.
 
43.
Cohen EB, Regev A, Garg A, et al. Consensus guidelines: best practices for the prevention, detection and management of hepatitis B virus reactivation in clinical trials with immunosuppressive/immunomodulatory therapy. Drug Saf 2024; 47: 321–332, DOI: 10.1007/s40264-024-01399-4.
 
44.
Valor-Méndez L, Manger B, Schett G, Kleyer A. Hepatitis-E-Virus-Infektion bei einem Patienten mit rheumatoider Arthritis unter Baricitinib-Therapie [Severe hepatitis E virus infection in a patient with rheumatoid arthritis treated with baricitinib]. Z Rheumatol 2021; 80: 980–983, DOI: 10.1007/s00393-021-01020-4 [Article in German].
 
45.
Pan C, Cao M, Yan C, et al. Hepatitis B virus reactivation associated with Janus kinase (JAK) inhibitors: a retrospective study of pharmacovigilance databases and review of the lite­rature. Expert Opin Drug Saf 2023; 22: 469–476, DOI: 10.1080/ 14740338.2023.2181339.
 
46.
Wang J, Zhang X, Geng X, et al. Risk of hepatitis B virus reactivation following treatment with abatacept: a retrospective study of international pharmacovigilance databases. EClinical­Medicine 2022; 48: 101425, DOI: 10.1016/j.eclinm.2022.101425.
 
47.
Hong X, Xiao Y, Xu L, et al. Risk of hepatitis B reactivation in HBsAg-/HBcAb+ patients after biologic or JAK inhibitor therapy for rheumatoid arthritis: a meta-analysis. Immun Inflamm Dis 2023; 11: e780, DOI: 10.1002/iid3.780.
 
48.
Sato K, Inoue J, Kakazu E, et al. Reactivation of hepatitis C virus with severe hepatitis flare during steroid administration for interstitial pneumonia. Clin J Gastroenterol 2021; 14: 1221–1226, DOI: 10.1007/s12328-021-01432-4.
 
49.
Kaneko H, Ozono Y, Iwakiri H, et al. Reactivation of hepatitis C virus caused by steroid monotherapy for sudden deafness. Clin J Gastroenterol 2024; 17: 505–510, DOI: 10.1007/s12328-024-01944-9.
 
50.
Hörl WH. Nonsteroidal anti-inflammatory drugs and the kidney. Pharmaceuticals (Basel) 2010; 3: 2291–2321, DOI: 10.3390/ph3072291.
 
51.
Hasselström J, Eriksson S, Persson A, et al. The metabolism and bioavailability of morphine in patients with severe liver cirrhosis. Br J Clin Pharmacol 1990; 29: 289–297, DOI: 10.1111/ j.1365-2125.1990.tb03638.x.
 
52.
Haberer JP, Schoeffler P, Couderc E, Duvaldestin P. Fentanyl pharmacokinetics in anaesthetized patients with cirrhosis. Br J Anaesth 1982; 54: 1267–1270, DOI: 10.1093/bja/ 54.12.1267.
 
53.
Moon AM, Jiang Y, Rogal SS, et al. Opioid prescriptions are associated with hepatic encephalopathy in a national cohort of patients with compensated cirrhosis. Aliment Pharmacol Ther 2020; 51: 652–660, DOI: 10.1111/apt.15639.
 
54.
Dropulic LK, Lederman HM. Overview of infections in the immunocompromised host. Microbiol Spectr 2016; 4: 10.1128/microbiolspec.DMIH2-0026-2016, DOI: 10.1128/microbiolspec. DMIH2-0026-2016.
 
55.
Udomkarnjananun S, Francke MI, De Winter BCM, et al. Therapeutic drug monitoring of immunosuppressive drugs in hepatology and gastroenterology. Best Pract Res Clin Gastroenterol 2021; 54–55: 101756, DOI: 10.1016/j.bpg.2021.101756.
 
56.
Glowacka P, Rudnicka L, Warszawik-Hendzel O, et al. The anti­viral properties of cyclosporine. Focus on coronavirus, hepatitis C virus, influenza virus, and human immunodeficiency virus infections. Biology (Basel) 2020; 9: 192, DOI: 10.3390/biology9080192.
 
57.
Rabie R, Mumtaz K, Renner EL. Efficacy of antiviral therapy for hepatitis C after liver transplantation with cyclosporine and tacrolimus: a systematic review and meta-analysis. Liver Transpl 2013; 19: 36–48, DOI: 10.1002/lt.23516.
 
58.
Salvi M, Macaluso L, Luci C, et al. Safety and efficacy of anti- tumor necrosis factors  in patients with psoriasis and chronic hepatitis C. World J Clin Cases 2016; 4: 49–55, DOI: 10.12998/wjcc.v4.i2.49.
 
59.
Verma R, Hendrix R, Saleem N, et al. S2663 Belimumab- associated reactivation of pre-core hepatitis B resulting in fatal fulminant hepatic failure. Am J Gastroenterol 2020; 115: S1395, DOI: 10.14309/01.ajg.0000712700.95945.81.
 
60.
May DG, Arns PA, Richards WO, et al. The disposition of dapsone in cirrhosis. Clin Pharmacol Ther 1992; 51: 689–700, DOI: 10.1038/clpt.1992.81.
 
61.
Megna M, Patruno C, Bongiorno MR, et al. Hepatitis virus reactivation in patients with psoriasis treated with secukinumab in a real-world setting of hepatitis B or hepatitis C infection. Clin Drug Investig 2022; 42: 525–531, DOI: 10.1007/s40261-022- 01163-5.
 
62.
Liu S, He Z, Wu W, et al. Safety of secukinumab in the treatment of patients with axial spondyloarthritis and concurrent hepatitis B virus infection or latent tuberculosis infection. Clin Rheumatol 2023; 42: 2369–2376, DOI: 10.1007/s10067-023-06630-8.
 
63.
Megna M, Lauletta G, Tommasino N, et al. Management of psoriasis patients with serious infectious diseases. Adv Ther 2024; 41: 2099–2111, DOI: 10.1007/s12325-024-02873-2.
 
64.
Tsentemeidou A, Sotiriou E, Sideris N, et al. Apremilast in psoriasis patients with serious comorbidities: a case series and systematic review of literature. Dermatol Pract Concept 2022; 12: e2022179, DOI: 10.5826/dpc.1204a179.
 
65.
Siegel SAR, Winthrop KL, Ehst BD, Ortega Loayza A. Ustekinumab use in patients with severe psoriasis co-infected with hepatitis B and/or C. Br J Dermatol 2019; 180: 1232–1233, DOI: 10.1111/bjd.17444.
 
66.
Glal KAM, El-Haggar SM, Abdel-Salam SM, Mostafa TM. Allopurinol prevents cirrhosis-related complications: a quadruple blind placebo-controlled trial. Am J Med 2024; 137: 55–64, DOI: 10.1016/j.amjmed.2023.09.016.
 
67.
Khosravan R, Grabowski BA, Mayer MD, et al. The effect of mild and moderate hepatic impairment on pharmacokinetics, pharmacodynamics, and safety of febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase. J Clin Pharmacol 2006; 46: 88–102, DOI: 10.1177/0091270005282634.
 
68.
Leighton JA, Bay MK, Maldonado AL, et al. Colchicine clearance is impaired in alcoholic cirrhosis. Hepatology 1991; 14: 1013–1015.
 
69.
Cocco G, Chu DC, Pandolfi S. Colchicine in clinical medicine. A guide for internists. Eur J Intern Med 2010; 21: 503–508, DOI: 10.1016/j.ejim.2010.09.010.
 
70.
Guarino M, Loperto I, Camera S, et al. Osteoporosis across chronic liver disease. Osteoporos Int 2016; 27: 1967–1977, DOI: 10.1007/s00198-016-3512-z.
 
71.
Lima TB, Santos LAA, Nunes HRC, et al. Safety and efficacy of risedronate for patients with esophageal varices and liver cirrhosis: a non-randomized clinical trial. Sci Rep 2019; 9: 18958, DOI: 10.1038/s41598-019-55603-y.
 
72.
Saeki C, Saito M, Oikawa T, et al. Effects of denosumab treatment in chronic liver disease patients with osteoporosis. World J Gastroenterol 2020; 26: 4960–4971, DOI: 10.3748/wjg.v26.i33. 4960.
 
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
eISSN:2084-9834
ISSN:0034-6233
Journals System - logo
Scroll to top