Clinical Implications
Dr. Soriano says the study findings suggest rheumatologists may expect elevated liver enzyme levels regardless of the presence of hepatic steatosis in a low percentage of patients. Because this study only included patients with mild to moderate hepatic steatosis, more research is needed to evaluate the effects of tofacitinib on C-reactive protein and liver enzymes, as well as the potential effect on clinical response, in patients with RA, PsA or psoriasis who have severe hepatic steatosis.
Dr. Soriano and his colleagues plan to obtain follow-up data from this study over a longer time period. They also hope to get data from observational cohorts, which will likely include patients with more severe hepatic steatosis.
Carina Stanton is a freelance science journalist based in Denver.
References
- Soriano ER, Madariaga H, Castañeda O, et al. Liver enzyme abnormalities after tofacitinib treatment in patients with hepatic steatosis from the rheumatoid arthritis, psoriatic arthritis and psoriasis clinical programs [abstract]. Arthritis Rheumatol. 2018; 70 Oct;70(suppl 10).
- Soriano ER, Madariaga H, Castañeda O, et al. Liver enzyme abnormalities after tofacitinib treatment in patients with hepatic steatosis from the rheumatoid arthritis, psoriatic arthritis and psoriasis clinical programs [abstract]. Ann Rheum Dis. 2018 Jun 15;77(suppl 2):593–594.
- Di Minno MND, Peluso R, Iervolino S, et al. Hepatic steatosis, carotid plaques and achieving MDA in psoriatic arthritis patients starting TNF-α blockers treatment: A prospective study. Arthritis Res Ther. 2012;14(5):R211.
