Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort
Objective Elevated tumour necrosis factor (TNF)-α has been implicated in the progression of liver fibrosis and pathogenesis of non-alcoholic fatty liver disease (NAFLD). We aim to investigate the impact of anti-TNF-α agents on the development of cirrhosis and NAFLD.Design This retrospective cohort s...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-12-01
|
| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/7/1/e000349.full |
| _version_ | 1826978313153806336 |
|---|---|
| author | Susan Hutfless Ruben Hernaez Kuo-Tung Tang Jean-François Dufour Po-Hung Chen |
| author_facet | Susan Hutfless Ruben Hernaez Kuo-Tung Tang Jean-François Dufour Po-Hung Chen |
| author_sort | Susan Hutfless |
| collection | DOAJ |
| description | Objective Elevated tumour necrosis factor (TNF)-α has been implicated in the progression of liver fibrosis and pathogenesis of non-alcoholic fatty liver disease (NAFLD). We aim to investigate the impact of anti-TNF-α agents on the development of cirrhosis and NAFLD.Design This retrospective cohort study used a US claims database between 1 January 2010 and 31 December 2016. We identified adult patients with ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis or rheumatoid arthritis. Anti-TNF-α agents of interest included adalimumab, certolizumab, etanercept, golimumab and infliximab. The primary composite outcome was the development of new-onset cirrhosis, NAFLD or non-alcoholic steatohepatitis (NASH). The secondary outcomes were the development of (1) cirrhosis and (2) NAFLD or NASH. Propensity score for anti-TNF-α agent use was generated by logistic regression. Cox proportional hazard models adjusting for the propensity score were used with regard to time-varying anti-TNF-α agent exposure.Results This study included 226 555 incident patients with immune-related diseases. During the median 1.5 years follow-up, there was an increased hazard with anti-TNF-α agent use in regard to liver outcomes (composite outcome HR: 1.47, 95% CI 1.27 to 1.70; cirrhosis HR 1.47, 95% CI 0.96 to 2.23; NAFLD or NASH HR 1.53, 95% CI 1.32 to 1.77). The composite outcome hazard was increased for each immune-related disease (HR 1.25–1.90).Conclusion In the short term, we did not observe a beneficial effect of anti-TNF-α agent use for development of cirrhosis, NAFLD or NASH in patients with immune-related diseases. |
| first_indexed | 2024-12-17T23:15:06Z |
| format | Article |
| id | doaj.art-99c9a7ddf3b9414b8040b59dc18a5f9f |
| institution | Directory Open Access Journal |
| issn | 2054-4774 |
| language | English |
| last_indexed | 2025-02-17T17:26:09Z |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj.art-99c9a7ddf3b9414b8040b59dc18a5f9f2024-12-14T19:30:08ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742020-12-017110.1136/bmjgast-2019-000349Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohortSusan Hutfless0Ruben Hernaez1Kuo-Tung Tang2Jean-François Dufour3Po-Hung Chen41 Johns Hopkins University, Baltimore, Maryland, USAGastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, TaiwanHepatology, Depertment of Biomedical Research, University of Bern, Bern, SwitzerlandDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USAObjective Elevated tumour necrosis factor (TNF)-α has been implicated in the progression of liver fibrosis and pathogenesis of non-alcoholic fatty liver disease (NAFLD). We aim to investigate the impact of anti-TNF-α agents on the development of cirrhosis and NAFLD.Design This retrospective cohort study used a US claims database between 1 January 2010 and 31 December 2016. We identified adult patients with ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis or rheumatoid arthritis. Anti-TNF-α agents of interest included adalimumab, certolizumab, etanercept, golimumab and infliximab. The primary composite outcome was the development of new-onset cirrhosis, NAFLD or non-alcoholic steatohepatitis (NASH). The secondary outcomes were the development of (1) cirrhosis and (2) NAFLD or NASH. Propensity score for anti-TNF-α agent use was generated by logistic regression. Cox proportional hazard models adjusting for the propensity score were used with regard to time-varying anti-TNF-α agent exposure.Results This study included 226 555 incident patients with immune-related diseases. During the median 1.5 years follow-up, there was an increased hazard with anti-TNF-α agent use in regard to liver outcomes (composite outcome HR: 1.47, 95% CI 1.27 to 1.70; cirrhosis HR 1.47, 95% CI 0.96 to 2.23; NAFLD or NASH HR 1.53, 95% CI 1.32 to 1.77). The composite outcome hazard was increased for each immune-related disease (HR 1.25–1.90).Conclusion In the short term, we did not observe a beneficial effect of anti-TNF-α agent use for development of cirrhosis, NAFLD or NASH in patients with immune-related diseases.https://bmjopengastro.bmj.com/content/7/1/e000349.full |
| spellingShingle | Susan Hutfless Ruben Hernaez Kuo-Tung Tang Jean-François Dufour Po-Hung Chen Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort BMJ Open Gastroenterology |
| title | Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort |
| title_full | Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort |
| title_fullStr | Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort |
| title_full_unstemmed | Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort |
| title_short | Antitumour necrosis factor-α agents and development of new-onset cirrhosis or non-alcoholic fatty liver disease: a retrospective cohort |
| title_sort | antitumour necrosis factor α agents and development of new onset cirrhosis or non alcoholic fatty liver disease a retrospective cohort |
| url | https://bmjopengastro.bmj.com/content/7/1/e000349.full |
| work_keys_str_mv | AT susanhutfless antitumournecrosisfactoraagentsanddevelopmentofnewonsetcirrhosisornonalcoholicfattyliverdiseasearetrospectivecohort AT rubenhernaez antitumournecrosisfactoraagentsanddevelopmentofnewonsetcirrhosisornonalcoholicfattyliverdiseasearetrospectivecohort AT kuotungtang antitumournecrosisfactoraagentsanddevelopmentofnewonsetcirrhosisornonalcoholicfattyliverdiseasearetrospectivecohort AT jeanfrancoisdufour antitumournecrosisfactoraagentsanddevelopmentofnewonsetcirrhosisornonalcoholicfattyliverdiseasearetrospectivecohort AT pohungchen antitumournecrosisfactoraagentsanddevelopmentofnewonsetcirrhosisornonalcoholicfattyliverdiseasearetrospectivecohort |