Chinese expert consensus on diagnosis and treatment of antirheumatic drug-induced liver injury(2024)

Abstract

Rheumatic diseases are a common group of chronic diseases that typically require long-term medication to control. Antirheumatic drugs may cause liver damage which requires prompt detection treatment to avoid irreversible damage. Liver damage induced by medication for rheumatoid arthritis has unique clinical manifestations and is difficult to distinguish from liver diseases related to the primary illness, often requiring the involvement of hepatologists to discuss and determine the treatment plan. To improve the understanding and management of anti rheumatic drug-induced liver injury among clinicians, especially rheumatologists, the Rheumatology Branch of the Chinese Medical Association and other experts in related fields formed this consensus after multiple discussions and revisions based on relevant research progress in recent years. Based on the Chinese Guidelines for diagnosis and management of drug-induced liver injury (2023), this consensus highlights the characteristics of rheumatic diseases and rheumatology medications, clarifies the anti rheumatic drugs that can cause liver injury, the liver injury caused by rheumatic diseases, the susceptible groups of anti rheumatic drug-induced injury, the diagnostic process of anti rheumatic drug-induced liver injury, and the indications for rheumatology physicians' consultation in the case of anti rheumatic drug-induced liver injury. It is hoped that the content of this consensus will be useful for practicing rheumatologists and that it can provide guidance for rheumatologists in the scientific management of anti rheumatic drug-induced liver injury.