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Published on: February 3, 2012
Risk of Autoimmune Hepatitis Among Patients with Inflammatory Bowel Disease Treated with Infliximab: A Retrospective
Hamza Almusabeh1,2, Zack Kovach3, Laurel Lloyd3
1Department of Internal Medicine, West Virginia University School of Medicine, Morgantown, WV, USA. Hamza.Almusabeh@hsc.wvu.edu.
Infliximab, an anti-tumor necrosis factor agent, showed a higher risk of autoimmune hepatitis in inflammatory bowel disease patients compared to adalimumab. This finding highlights potential safety differences between these common treatments.
Area of Science:
- Gastroenterology and Hepatology
- Immunology
- Pharmacovigilance
Background:
- Infliximab and adalimumab are common anti-tumor necrosis factor therapies for inflammatory bowel disease (IBD).
- Both agents have been linked to drug-induced autoimmune hepatitis (AIH).
- Comparative risk data for AIH between infliximab and adalimumab in IBD is limited.
Purpose of the Study:
- To compare the risk of developing autoimmune hepatitis in patients with inflammatory bowel disease treated with infliximab versus adalimumab.
- To evaluate safety profiles of two major anti-tumor necrosis factor agents.
Main Methods:
- Retrospective cohort study using the TriNetX US network.
- Included new users of infliximab or adalimumab for Crohn's disease or ulcerative colitis.
- Propensity score matching used to balance baseline characteristics; excluded patients with prior AIH or other biologic exposure.
Main Results:
- After matching, 15,298 patients were in each group.
- Autoimmune hepatitis occurred in 0.216% of infliximab users vs. 0.085% of adalimumab users.
- Infliximab was associated with a significantly higher risk of AIH (RR 2.53, P=0.0032).
Conclusions:
- Infliximab use in IBD patients is associated with a higher observed risk of autoimmune hepatitis compared to adalimumab.
- This finding suggests a potential difference in hepatotoxicity between these anti-tumor necrosis factor agents.
- Further research may be warranted to elucidate mechanisms and clinical implications.
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