Document Detail


Hepatic steatosis and disease activity in subjects with psoriatic arthritis receiving tumor necrosis factor-α blockers.
MedLine Citation:
PMID:  22422493     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Little is known about tumor necrosis factor-α (TNF-α) blockers, disease activity, and liver steatosis (hepatic steatosis; HS) in subjects with psoriatic arthritis (PsA). We prospectively evaluated changes in HS during treatment with TNF-α blockers.
METHODS: In 48 patients with PsA who had evidence of HS before the beginning of TNF-α blocker treatment, an ultrasound followup examination was performed after a 12-month treatment period with TNF-α blockers. All subjects were stratified according to minimal disease activity (MDA) or not (n-MDA), during treatment with TNF-α blockers. Changes in grade of HS were evaluated in parallel in 42 controls with HS and without PsA.
RESULTS: At baseline, no significant difference in HS score was found between PsA subjects and controls (HS scores 1.46 ± 0.65 vs 1.62 ± 0.66, respectively; p = 0.249). At 12-month followup, a worsening HS score was found in 20 (41.7%) patients with PsA and in 6 (14.3%) controls (p = 0.005). Overall, the grade of HS worsening was higher in patients with PsA (0.37 ± 0.70) than in controls (0.09 ± 0.43; p = 0.028). A significantly lower prevalence of worsening HS was found among patients with PsA with MDA, compared with n-MDA subjects (16.7% vs 66.7%, respectively; p = 0.001). Laboratory measures of liver function behaved similarly. The risk of worsening HS in patients with PsA who had MDA was similar to that in controls (HR 1.20, 95% CI 0.34-4.33, p = 0.77), and higher in patients who did not have MDA (HR 4.46, 95% CI 1.73-11.47, p = 0.001, regression analysis).
CONCLUSION: Compared with patients with MDA, those with active disease after 12-month treatment with TNF-α blockers exhibited significantly higher incidence of worsening liver steatosis.
Authors:
Matteo Nicola Dario Di Minno; Salvatore Iervolino; Rosario Peluso; Anna Russolillo; Roberta Lupoli; Raffaele Scarpa; Giovanni Di Minno; Giovanni Tarantino;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-03-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  39     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-02     Completed Date:  2013-02-04     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1042-6     Citation Subset:  IM    
Affiliation:
Department of Clinical and Experimental Medicine, Regional Reference Centre for Coagulation Disorders, Rheumatology Research Unit, Psoriatic Arthritis Clinic, Federico II University, Naples, Italy. dario.diminno@hotmail.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / administration & dosage,  adverse effects
Antibodies, Monoclonal, Humanized / administration & dosage,  adverse effects
Antirheumatic Agents / administration & dosage,  adverse effects*
Arthritis, Psoriatic / drug therapy*,  epidemiology
Fatty Liver / chemically induced*,  epidemiology,  ultrasonography
Female
Follow-Up Studies
Humans
Immunoglobulin G / administration & dosage,  adverse effects
Male
Middle Aged
Prospective Studies
Receptors, Tumor Necrosis Factor / administration & dosage
Severity of Illness Index
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein; FYS6T7F842/adalimumab
Investigator
Investigator/Affiliation:
Paolo Osvaldo Rubba / ; Biagio De Simone / ; Marco Gentile /

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