Shenavandeh Saeedeh, Taghavi Seyed Alireza, Nekooeian AliAkbar, Moini Maryam
Division of Rheumatology, Department of Internal Medicine, Shiraz University of Medical Science, Iran.
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Iran.
Reumatologia. 2024;62(4):282-293. doi: 10.5114/reum/191791. Epub 2024 Sep 16.
The presence of chronic liver diseases such as metabolic dysfunction-associated steatosis liver disease, viral hepatitis, and cirrhosis may affect the treatment plan in patients with rheumatologic disorders, with concern about the adverse effects of the rheumatic medications on the course of liver disease. Advanced liver disease can change the elimination and activation of many drugs. In addition, there are concerns about the risk of viral reactivation after using biologics and immunosuppressants in patients with chronic viral hepatitis. This narrative review will assess the considerations that should be made before starting the most frequently used drugs in all common rheumatic diseases and patients with chronic liver diseases including chronic viral hepatitis.
代谢功能障碍相关脂肪性肝病、病毒性肝炎和肝硬化等慢性肝病的存在可能会影响风湿性疾病患者的治疗方案，因为人们担心风湿药物对肝病病程的不良影响。晚期肝病会改变许多药物的消除和活化过程。此外，对于慢性病毒性肝炎患者使用生物制剂和免疫抑制剂后病毒再激活的风险也存在担忧。这篇叙述性综述将评估在所有常见风湿性疾病以及包括慢性病毒性肝炎在内的慢性肝病患者开始使用最常用药物之前应考虑的因素。
