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07-04-2018 | Rheumatoid arthritis | Review | Article

Clinical connection between rheumatoid arthritis and liver damage

Journal: Rheumatology International

Authors: Biljana Radovanović-Dinić, Snežana Tešić-Rajković, Valentina Zivkovic, Saša Grgov

Publisher: Springer Berlin Heidelberg

Abstract

When liver damage is present in rheumatoid arthritis (RA) patients, it is sometimes difficult to determine whether it is a hepatic manifestation of RA, associated primary liver disease or hepatotoxic liver disease which developed during the treatment of RA. Liver damage during RA is most common in the form of asymptomatic abnormal liver tests. Occasionally, liver damage may progress to cirrhosis. Patients with RA are more susceptible to an associated autoimmune liver disease. Medications used in rheumatology are often hepatotoxic and it is difficult to differentiate between hepatic manifestations of the primary disease and potential hepatotoxicity of the administered medications. The significance of the paper is in the fact that it includes the most relevant and the latest information on this commonly present problem in clinical practice. The aim of the author is to provide comprehensive but at the same time concise data which will be useful to the doctors who come into contact with RA patients with symptomatic or asymptomatic liver disease. Timely diagnosis and treatment of liver disease in RA patients can significantly influence the course and outcome of rheumatoid arthritis.
Literature
1.
Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. Lancet 388(10055):2023–2038CrossRefPubMed
2.
Shimoda S, Chong Y, Akahoshi M, Niiro H, Tsukamoto H (2016) Hepatic and gastrointestinal manifestations in rheumatic and connective tissue diseases. J Gen Fam Med 17(2):132–137CrossRef
3.
Hocking WG, Lasser K, Ungerer R, Bersohn M, Palos M, Spiegel T (1981) Spontaneous hepatic rupture in rheumatoid arthritis. Arch Intern Med 141:792–794CrossRefPubMed
4.
Chentoufi AA, Serov YA, Alazmi M, Baba K (2014) Immune components of liver damage associated with connective tissue diseases. J Clin Transl Hepatol 2(1):37–44PubMedPubMedCentral
5.
Soultati A, Dourakis S (2005) Hepatic manifestations of autoimmune rheumatic diseases. Ann Gastroenterol 18(3):309–324
6.
Selmi C, De Santis M, Gershwin ME (2011) Liver involvement in subjects with rheumatic disease. Arthritis Res Ther 13:226CrossRefPubMedPubMedCentral
7.
Kojima H, Uemura M, Sakurai S, Ann T, Ishii Y, Imazu H, Yoshikawa M, Ichijima K, Fukui H (2002) Clinical features of liver disturbance in rheumatoid diseases: clinicopathological study with special reference to the cause of liver disturbance. J Gastroenterol 37:617–625CrossRefPubMed
8.
Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31(11):1409–1417. https://​doi.​org/​10.​1007/​s00296-011-1999-3 CrossRefPubMed
9.
Still GF (1897) On a form of chronic joint disease in children. Med Chir Trans 80:47–60CrossRefPubMedPubMedCentral
10.
Ebert EC, Hagspiel KD (2011) Gastrointestinal and hepatic manifestations of rheumatoid arthritis. Dig Dis Sci 56(2):295–302CrossRefPubMed
11.
Lee JE, Kim IJ, Cho MS, Lee J (2017) A case of rheumatoid vasculitis involving hepatic artery in early rheumatoid arthritis. J Korean Med Sci 32(7):1207–1210CrossRefPubMedPubMedCentral
12.
Das S, Padhan P (2017) An overview of the extraarticular involvement in rheumatoid arthritis and its management. J Pharmacol Pharmacother 8(3):81–86PubMedPubMedCentral
13.
Rigby WFC, Lampl K, Low JM, Furst DE (2017) Review of routine laboratory monitoring for patients with rheumatoid arthritis receiving biologic or nonbiologic DMARDs. Int J Rheumatol 2017:9614241CrossRefPubMedPubMedCentral
14.
Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD (2013) Liver involvement in patients with systemic autoimmune diseases. Medica 8(4):394–397
15.
Ruderiman EM, Crawford JM, Maier A, Liu JJ, Gravallese EM, Weinblatt ME (1997) Histologic liver abnormalities in an autopsy series of patients with rheumatoid arthritis. Br J Rheumatol 36(2):210–213CrossRef
16.
Mills PR, MacSween RN, Dick WC, More IA, Watkinson G (1980) Liver disease in rheumatoid arthritis. Scott Med J 25(1):18–22CrossRefPubMed
17.
Selmi C, Mackay IR, Gershwin ME (2007) The immunological milieu of the liver. Semin Liver Dis 27:129–139CrossRefPubMed
18.
Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD (2009) Liver biopsy. Hepatology 49:1017–1044CrossRefPubMed
19.
Mizuno K, Ikeda K, Saida Y, Takenaka R, Shibata M, Takeuchi T (1996) Hepatic hemorrhage in malignant rheumatoid arthritis. Am J Gastroenterol 91:2624–2625PubMed
20.
Matsumoto T, Kobayashi S, Shimizu H, Nakajima M, Watanabe S, Kitami N, Sato N, Abe H, Aoki Y, Hoshi T, Hashimoto H (2000) The liver in collagen diseases: pathologic study of 160 cases with particular reference to hepatic arteritis, primary biliary cirrhosis, autoimmune hepatitis and nodular regenerative hyperplasia of the liver. Liver 20:366–373CrossRefPubMed
21.
Blank M, Gershwin ME (2008) Autoimmunity: from the mosaic to the kaleidoscope. J Autoimmun 30:1–4CrossRefPubMed
22.
Poupon R (2010) Primary biliary cirrhosis: a 2010 update. J Hepatol 52:745–758CrossRefPubMed
23.
Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ (2009) Primary biliary cirrhosis. Hepatology 50:291–308CrossRefPubMed
24.
Karlsen TH, Vesterhus M, Boberg KM (2014) Controversies in the management of primary biliary cirrhosis and primary sclerosing cholangitis. Aliment Pharmacol Ther 39(3):282–230CrossRefPubMed
25.
Reshetnyak (2014) Primary biliary cirrhosis: clinical and laboratory criteria for its diagnosis. World J Gastroenterol 21(25):7683–7708CrossRef
26.
Liaskos C, Bogdanos DP, Rigopoulou EI, Dalekos GN (2007) Development of antimitochondrial antibodies in patients with autoimmune hepatitis: art of facts or an artifact? J Gastroenterol Hepatol 22(3):454–455CrossRefPubMed
27.
Bogdanos DP, Komorowski L (2011) Disease-specific autoantibodies in primary biliary cirrhosis. Clin Chim Acta 412(7–8):502–512CrossRefPubMed
28.
Siegel JL, Luthra H, Donlinger J, Angulo P, Lindor K (2003) Association of primary biliary cirrhosis and rheumatoid arthritis. J Clin Rheumatol 9(6):340–343CrossRefPubMed
29.
Whaley K, Goudie RB, Williamson J, Nuki G, Dick WC, Buchanan WW (1970) Liver disease in Sjogren’s syndrome and rheumatoid arthritis. Lancet i:861–863CrossRef
30.
Smyk DS, Bogdanos DP, Mytilinaiou MG, Burroughs AK, Rigopoulou EI (2012) Rheumatoid arthritis and primary biliary cirrhosis: cause, consequence, or coincidence? Hindawi Publ Corp Arthritis. https://​doi.​org/​10.​1155/​2012/​391567 (article ID 391567, 7 pages)
31.
Mitchell MM, Lleo A, Zammataro L et al (2011) Epigenetic investigation of variably X chromosome inactivated genes in monozygotic female twins discordant for primary biliary cirrhosis. Epigenetics 6(1):95–102. https://​doi.​org/​10.​4161/​epi.​6.​1.​13405 CrossRefPubMedPubMedCentral
32.
Ospelt C, Reedquist KA, Gay S, Tak PP (2011) Inflammatory memories: Is epigenetics the missing link to persistent stromal cell activation in rheumatoid arthritis? Autoimmun Rev 10(9):519–524CrossRefPubMed
33.
Bogdanos DP, Baum H, Vergani D, Burroughs AK (2010) The role of E. coli infection in the pathogenesis of primary biliary cirrhosis. Dis Mark 29:301–311CrossRef
34.
Varyani FK, West J, Card TR (2011) An increased risk of urinary tract infection precedes development of primary biliary cirrhosis. BMC Gastroenterol 11:95CrossRefPubMedPubMedCentral
35.
Wilson C, Thakore D, Isenberg D, Ebringer A (1997) Correlation between anti Proteus antibodies and isolation rates of P. mirabilis in rheumatoidarthritis. Rheumatol Int 16:187–189CrossRefPubMed
36.
Tiwana H, Wilson C, Walmsley RS, Wakefield AJ, Smith MS, Cox NL, Hudson MJ, Ebringer A (1997) Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn’s disease and ulcerative colitis. Rheumatol Int 17(1):11–16CrossRefPubMed
37.
Marasini B, Gagetta M, Rossi V, Ferrari P (2001) Rheumatic disorders and primary biliary cirrhosis: an appraisal of 170 Italian patients. Ann Rheum Dis 60(11):1046–1049CrossRefPubMedPubMedCentral
38.
Wolf DC (2017) Autoimmune hepatitis clinical presentation. IOP Publishing PhysicsWeb. https://​emedicine.​medscape.​com/​article/​172356-clinical#b3. Accessed 25 Sept 2017
39.
Toulemonde G, Scoazec JY, Miossec P (2012) Treatment with etanercept of autoimmune hepatitis associated with rheumatoid arthritis: an open label proof of concept study. Ann Rheum Dis 71:1423–1424CrossRefPubMed
40.
Tischendorf JJ, Hecker H, Kruger M, Manns MP, Meier PN (2007) Characterization, outcome, and prognosis in 273 patients with primary sclerosing cholangitis: a single center study. Am J Gastroenterol 102:107–114CrossRefPubMed
41.
Hov JR, Boberg KM, Karlsen TH (2008) Autoantibodies in primary sclerosing cholangitis. World J Gastroenterol WJG 14(24):3781–3791. https://​doi.​org/​10.​3748/​wjg.​14.​3781 CrossRefPubMed
42.
Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ, American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association (2012) The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol 107(6):811–826 https://​doi.​org/​10.​1038/​ajg.​2012.​128 CrossRefPubMed
43.
Lim JS, Mietus-Snyder M, Valente A, Schwarz JM, Lustig RH (2010) The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome. Nat Rev Gastroenterol Hepatol 7(5):251–264CrossRefPubMed
44.
Arena U, Stasi C, Mannoni A, Benucci M, Maddali-Bongi S, Cammelli D, Assarat A, Marra F, Pinzani M (2012) Liver stiffness correlates with methotrexate cumulative dose in patients with rheumatoid arthritis. Dig Liver Dis 44(2):149–153CrossRefPubMed
45.
Ahmed MH, Byrne CD (2005) Non Alcoholic Steatohepatitis and Metabolic syndrome. In: Byrne C, Wild S (eds) Metabolic syndrome. Wiley, Chichester, pp 279–305
46.
Crowson CS, Matteson EL, Davis JM 3rd, Gabriel SE (2013) Contribution of obesity to the rise in incidence of rheumatoid arthritis. Arthritis Care Res (Hoboken) 65(1):71–77CrossRef
47.
Koivuniemi R, Paimela L, Suomalinen R, Tornroth T, Leirisalo-Repo M (2008) Amyloidosis is frequently undetected in patients with rheumatoid arthritis. Amyloid 15(4):262–268CrossRefPubMed
48.
Shimizu Y (2008) Liver in systemic disease. World J Gastroenterol 14(26):4111–4119CrossRefPubMedPubMedCentral
49.
Kumar R, Anandh K, Goel S (2015) Wilson’s disease masquerading as rheumatoid arthritis. Indian J Med Spec 6(1):33–35CrossRef
50.
Schilsky ML, Mistry P (2001) Metabolic liver disease. Curr Opin Gastroenterol 17(3):221–231CrossRefPubMed
51.
Cacoub P, Renou C, Rosenthal E, Cohen P, Loury I, Loustaud-Ratti V (2000) Extrahepatic manifestations associated with hepatitis C virus infection. A prospective multicenter study of 321patients. Extrahepatic manifestations associated with hepatitis C virus infection. A prospective multicenter study of 321 patients. The GERMIVIC. Groupe d’Etude et de Recherche en Medecine Interne et Maladies Infectieuses sur le Virus de l’Hepatite C. Medicine (Baltimore) 79(1):47–56CrossRef
52.
Cacoub P, Comarmond C (2017) New insights into HCV-related rheumatologic disorders: a review. J Adv Res 8(2):89–97CrossRefPubMed
53.
Koga T, Migita K, Miyashita T, Maeda Y, Nakamura M, Abiru S, Myoji M, Komori A, Yano K, Yatsuhashi H, Eguchi K, Ishibashi H (2008) Determination of anti-cyclic citrullinated peptide antibodies in the sera of patients with liver diseases. Clin Exp Rheumatol 26(1):121–124PubMed
54.
Maya R, Gershwin ME, Shoenfeld Y (2008) Hepatitis B virus (HBV) and autoimmune disease. Clin Rev Allergy Immunol 34(1):85–102. https://​doi.​org/​10.​1007/​s12016-007-8013-6 CrossRefPubMed
55.
Yılmaz N, Karadağ Ö, Kimyon G et al (2014) Prevalence of hepatitis B and C infections in rheumatoid arthritis and ankylosing spondylitis: a multicenter countrywide study. Eur J Rheumatol 1(2):51–54. https://​doi.​org/​10.​5152/​eurjrheumatol.​2014.​018 CrossRefPubMedPubMedCentral
56.
Guennoc X, Narbonne V, Jousse-Joulin S, Devauchelle-Pensec V, Dougados M, Daurres JP et al (2009) Is screening for hepatitis B and C useful in patients with recent-onset polyarthritis? Results of the ESPOIR cohort study. J Rheumatol 36(7):1407–1413CrossRefPubMed
57.
Zheng B, Li T, Lin Q, Huang Z, Wang M, Deng W, Liao Z, Gu J (2012) Prevalence of hepatitis B surface antigen in patients with ankylosing spondylitis and its association with HLA-B27: a retrospective study from south China. Rheumatol Int 32(7):2011–2016CrossRefPubMed
58.
Zerrak A, Bour JB, Tavernier C, Dougados M, Maillefert JF (2005) Usefulness of routine hepatitis C virus, hepatitis B virus, and parvovirus B19 serology in the diagnosis of recent-onset inflammatory arthritides. Arthritis Rheum 53(3):477–478CrossRefPubMed
59.
Lok AS, McMahon BJ (2009) Chronic hepatitis B: update 2009. Hepatology 50(3):661–662CrossRefPubMed
60.
Ghany MG, Strader DB, Thomas DL, Seeff LB, American Association for the Study of Liver Diseases (2009) Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 49(4):1335–1374CrossRefPubMed
61.
Saag KG, Teng GG, Patkar NM et al (2008) American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum 59(6):762–784CrossRefPubMed
62.
Palmore TN, Shah NL, Loomba R, Borg BB, Lopatin U, Feld JJ, Khokhar F, Lutchman G, Kleiner DE, Young NS, Childs R, Barrett AJ, Liang TJ, Hoofnagle JH, Heller T (2009) Reactivation of hepatitis B with reappearance of hepatitis B surface antigen after chemotherapy and immunosuppression. Clin Gastroenterol Hepatol 7(10):1130–1137CrossRefPubMedPubMedCentral
63.
Cacoub P, Gragnani L, Comarmonda C, Zignegoe AL (2014) Extrahepatic manifestations of chronic hepatitis C virus infection. Dig Liver Dis 46(5):S165–S173CrossRefPubMed
64.
Mori S, Fujiyama S (2015) Hepatitis B virus reactivation associated with antirheumatic therapy: risk and prophylaxis recommendations. World J Gastroenterol 21(36):10274–10289. https://​doi.​org/​10.​3748/​wjg.​v21.​i36.​10274 CrossRefPubMedPubMedCentral
65.
Nakamura J, Nagashima T, Nagatani K, Yoshio T, Iwamoto M, Minota S (2016) Reactivation of hepatitis B virus in rheumatoid arthritis patients treated with biological disease-modifying antirheumatic drugs. Int J Rheum Dis 19:470–475CrossRefPubMed
66.
Joseph AM (2012) Treatment of rheumatoid arthritis in patients with concomitant chronic hepatitis C infection. Ther Adv Musculoskelet Dis 4(1):35–40CrossRefPubMedPubMedCentral
67.
Mota LM, Cruz BA, Brenol CV et al (2013) Guidelines for the drug treatment of rheumatoid arthritis. Rev Bras Reumatol 53(2):158–183CrossRefPubMed
68.
Jensen KO, Angst E, Hetzer FH, Gingert C (2016) Acute cytomegalovirus hepatitis in an immunocompetent host as a reason for upper right abdominal pain. Case Rep Gastroenterol 10(1):36–43CrossRefPubMedPubMedCentral
69.
Trier N, Izarzugaza J, Chailyan A, Marcatili P, Houen G (2018) Human MHC-II with shared epitope motifs are optimal Epstein–Barr virus glycoprotein 42 ligands—relation to rheumatoid arthritis. Int J Mol Sci 19(1):317. https://​doi.​org/​10.​3390/​ijms19010317 CrossRefPubMedCentral
70.
Schiemann U, Kellner H (2002) Gastrointestinal side effects in the therapy of rheumatologic diseases. Z Gastroenetrol 40:937–943CrossRef
71.
Lacroix I, Lapeyre-Mestre M, Bagheri H, Pathak A, Montastruc JL (2004) Club de Reflexion des cabinets de Groupe de Gastro-Enterologie (CREGG); General practitioner networks nonsteroidal anti-inflamatory drug-induced liver injury; a case–control study in primary care. Fundam Clin Pharmacol 18(2):201–206CrossRefPubMed
72.
García Rodríguez LA, Williams R, Derby LE, Dean AD, Jick H (1994) Acute liver injury associated with nonsteroidal anti-inflammatory drugs and the role of risk factors. Arch Intern Med 154(3):311–316CrossRefPubMed
73.
Tyagi P, Sharma BC, Sarin SK (2005) Cholestatic liver injury due to ibuprofen. Indian J Gastroenterol 24(2):77–78PubMed
74.
Merlani G, Fox M, Oehen HP, Cathomas G, Renner EL, Fattinger K, Schneemann M, Kullak-Ublick GA (2001) Fatal hepatotoxicity secondary to nimesulide. Eur J Clin Pharmacol 57(4):321–326CrossRefPubMed
75.
Mills PR, Sturrock RD (1982) Clinical associations between arthritis and liver disease. Ann Rheum Dis 41:295–307CrossRefPubMedPubMedCentral
76.
Goto E, Tomojiri S, Okamoto I, Tanaka K (2001) Methotrexate poisoning with acute hepatorenal dysfunction. J Toxicol Clin Toxicol 39:101–104CrossRefPubMed
77.
Conway R, Carey JJ (2017) Risk of liver disease in methotrexate treated patients. World J Hepatol 9(26):1092–1100CrossRefPubMedPubMedCentral
78.
Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, Reed G, Strand V, Kremer JM (2010) Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide. Ann Rheum Dis 69(1):43–47CrossRefPubMedPubMedCentral
79.
Dirven L, Klarenbeek NB, van den Broek M, van Groenendael JH, de Sonnaville PB, Kerstens PJ, Huizinga TW, Dijkmans BA, Lems WF, Allaart CF (2013) Risk of alanine transferase (ALT) elevation in patients with rheumatoid arthritis treated with methotrexate in a DAS-steered strategy. Clin Rheumatol 32:585–590CrossRefPubMed
80.
Conway R, Low C, Coughlan RJ, O’Donnell MJ, Carey JJ (2015) Risk of liver injury among methotrexate users: a meta-analysis of randomised controlled trials. Semin Arthritis Rheum 45(2):156–162CrossRefPubMed
81.
Quintin E, Scoazec J-Y, Marotte H, Miossec P (2010) Rare incidence of methotrexate-specific lesions in liver biopsy of patients with arthritis and elevated liver enzymes. Arthritis Res Ther 12(4):R143. https://​doi.​org/​10.​1186/​ar3085 CrossRefPubMedPubMedCentral
82.
Dehestani V, Shariati-Sarabi Z, Mohiti S, Akhlaghi S (2015) Liver toxicity in rheumatoid arthritis patients treated with methotrexate. Asia Pac J Med Toxicol 4:102–105
83.
Schmajuk G, Miao Y, Yazdany J, Boscardin WJ, Daikh DI, Steinman MA (2014) Identification of risk factors for elevated transaminases in methotrexate users through an electronic health record. Arthritis Care Res (Hoboken) 66(8):1159–1166. https://​doi.​org/​10.​1002/​acr.​22294 CrossRef
84.
Whittle SL, Hughes RA (2004) Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review. Rheumatology 43(3):267–271CrossRefPubMed
85.
Prey S, Paul C (2009) Effect of folic or folinic acid supplementation on methotrexate-associated safety and efficacy in inflammatory disease: a systematic review. Br J Dermatol 160(3):622–628CrossRefPubMed
86.
Sakthiswary R, Chan GY, Koh ET, Leong KP, Thong BY (2014) Methotrexate-associated nonalcoholic fatty liver disease with transaminitis in rheumatoid arthritis. Sci World J 2014:823763CrossRef
87.
Malik F, Ranganathan P (2013) Methotrexate pharmacogenetics in rheumatoid arthritis: a status report. Pharmacogenomics 14(3):305–314. https://​doi.​org/​10.​2217/​pgs.​12.​214 CrossRefPubMed
88.
Owen SA, Lunt M, Bowes J, Hider SL, Bruce IN, Thomson W, Barton A (2013) MTHFR gene polymorphisms and outcome of methotrexate treatment in patients with rheumatoid arthritis: analysis of key polymorphisms and meta-analysis of C677T and A1298C polymorphisms. Pharmacogenom J 13(2):137–147CrossRef
89.
Aithal GP, Haugk B, Das S, Card T, Burt AD, Record CO (2004) Monitoring methotrexate-induced hepatic fibrosis in patients with psoriasis: are serial liver biopsies justified? Aliment Pharmacol Ther 19(4):391–399CrossRefPubMed
90.
Ros S, Juanola X, Condom E, Canas C, Riera J, Guardiola J et al (2002) Light and electron microscopic analysis of liver biopsy samples from rheumatoid arthritis patients receiving long-term methotrexate therapy. Scand J Rheumatol 31:330–336CrossRefPubMed
91.
Ledingham J, Gullick N, Irving K et al (2017) BSR and BHPR guideline for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs. Rheumatology 56(6):865–868. https://​doi.​org/​10.​1093/​rheumatology/​kew479 CrossRefPubMed
92.
Bird P, Griffiths H, Tymms K, Nicholls D, Roberts L, Arnold M, Burnet S, de Jager J, Scott J, Zochling J, Littlejohn G (2013) The SMILE study—safety of methotrexate in combination with leflunomide in rheumatoid arthritis. J Rheumatol 40(3):228–235CrossRefPubMed
93.
Smolen JS, Landewé R, Bijlsma J et al (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 76(6):960–977CrossRefPubMed
94.
Visser K, Katchamart W, Loza E, Martinez-Lopez JA, Salliot C, Trudeau J et al (2009) Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Ann Rheum Dis 68(7):1086–1093CrossRefPubMed
95.
Yeo W, Chan HL (2013) Hepatitis B virus reactivation associated with anti-neoplastic therapy. J Gastroenterol Hepatol 28(1):31–37CrossRefPubMed
96.
Droz N, Gilardin L, Cacoub P et al (2013) Kinetic profiles and management of hepatitis B virus reactivation in patients with immune-mediated inflammatory diseases. Arthritis Care Res (Hoboken) 65(9):1504–1514CrossRef
97.
Bersoff-Matcha SJ, Cao K, Jason M, Ajao A, Jones SC, Meyer T, Brinker A (2017) Hepatitis B virus reactivation associated with direct-acting antiviral therapy for chronic hepatitis c virus: a review of cases reported to the US Food and Drug Administration adverse event reporting system. Ann Intern Med 166(11):792–798CrossRefPubMed
98.
Brunasso AM, Puntoni M, Gulia A, Massone C (2011) Safety of anti-tumour necrosis factor agents in patients with chronic hepatitis C infection: a systematic review. Rheumatology 50(9):1700–1711CrossRefPubMed