Liver problems caused by biologics

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I started having elevated liver enzymes when I was on Humira. We decided to try Enbrel instead and it was more effective for me but it made my liver function even worse. Now my doctor thinks it may be drug-induced autoimmune hepatitis because I also have a positive ANA. My last dose of Enbrel was on 11/27 and my liver symptoms started to improve around 12/22. As I started to feel better overall, I have more RA pain which is a huge bummer. I feel it's more important to preserve my liver right now. 

Has anyone else had these kind of complications from biologics and did they resolve if/when you stopped taking them? 

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  • Posted

    Hi LeanaBeana, talk about Hobson’s Choice. It’s not good enough is it?  I’ve not had the same problem as you but I do have ongoing problems with meds the most recent, kidney function due to meds?  I don’t know about anyone else but when I feel ok my joint symptoms (I have psoriatic arthritis) fade into my memory but blimey, when I have to stop my biologics or other and the pain and disability come back big time, it’s terrible. I’m not much help but as I understand the liver is often able to recover and I sincerely hope this is the case for you. The challenge then is finding something else to control your symptoms that doesn’t affect your liver. More research essential! Hope you are able to enjoy the Christmas period. Carol x
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    • Posted

      Thanks Carol. I anticipate much more experimentation with meds, but I have to admit I'm a bit gun shy about trying anything new. Methotrexate is hard on the liver as well. I also take Plaquenil but it doesn't make any noticeable difference. 

      I had a lab test earlier today so I do hope the news is good! 

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  • Posted

    Hi, I’ve been having the same problems with MTX causing liver problems and I’ve had to stop taking it. I was also on Cimzia biologic and that got changed to Actemra biologic which I loved as with the MTX it made me feel human again, more pain when MTX was stopped. Unfortunately the Actemra was upsetting both my liver and diverticulosis and I’m due to change it again in January not sure what to yet. My liver results are very bad at the moment so no alcohol or fried foods etc. which will help it.

    I live in a cooler part of Australia but visiting family over the holiday and the temps are in the 40’s which has caused a big flare up so taking Predisolone steroids for a few days to bring the pain levels down. I agree that our liver and kidneys need protecting and it seems sometimes that it’s a balancing act between being pain free and damage. Hope you find a balance soon.

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    • Posted

      Hi Mary. Sorry to hear your liver is not doing well. I hope you find something that works for your RA that doesn't tax the liver. 

      My pain seems to be back with a vengeance, so I wonder if it's a rebound effect. I'm sure the cold isn't helping. 

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    • Posted

      Cold and heat seems to make it worse, we can’t win but I always look back to my sister in law who started with RA 40 years ago and all she was offered was gold injections and warm wax massages, she used to cry with pain. We have so much more options now we just have to find the right combo. I’m also very lucky that when this hit me I was so close to retirement age that I was able to give up work and relax, I don’t envy those still working.
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    • Posted

      Would your doctor consider some steroids to control your pain in the interim? I do understand your concern about trying new medication but when you’re in pain... incidentally I had to stop methotrexate as it’s caused some lung fibrosis. It’s improved since stopping it but my lung function isn’t what it was. I also appreciate what Mary says about more available treatment, I also remember patients coming to the hospital for gold injections but there was little else. The treatment we have even now, does seem lacking and pretty toxic but yes, better than it was. Good luck with your blood test. Carol 
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    • Posted

      Thanks Carol. I can't tolerate steroids because I also have bipolar disorder and they can trigger mood fluctuations. I emailed my rheumy and she is out of town so her partner answered. He didn't have the background on my liver stuff so he encouraged me to get back on Enbrel. I don't think there is anything they can prescribe besides an opiate without acetaminophen. 

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  • Posted

    Blimey, nothing is straightforward, is it? I really hope you get sorted out soon and you’re not in too much pain in the meantime. Carol x
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    • Posted

      Thanks Carol. My latest liver results came back yesterday and it was better news. AST is down from 98 to 74 and ALT is down from 135 to 92. They are still too high, but they were doubling before which was scary. My doctor is now convinced that Enbrel is the culprit. I see the liver specialist on 1/8. 

      My pain is really bad and it's been hard to keep my balance. I was at a friend's house which is all tricked out with railings from when her grandmother was still alive. I realized how nice it is to be able to brace myself with something! It may be time to get a cane, but I'm in denial. 

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    • Posted

      Well, a downward trend which is good for your liver but doesn't help your joints much. I don't know what they might suggest next but hope you aren't in too much pain for long and get to see your Rheumy soon. You sound like you are struggling. If you need some walking or other aids why not use them. Hopefully, it won't be for long. Do you use ice packs or TENS? Maybe worth trying? I know I keep saying it but these meds are so toxic, they're scary.  Thinking of you. Carol

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  • Posted

    Hi leanabeana

    I was on humira which caused major side effects including liver enzymes raised . I was on prednisone for 2 years and have come off them completely to commence biologics i am now on acterma. This has causez upper respiratory infection and UTI.

    Rheummy suggested a 3 week break and after 3 weeks of antibiotics starting to feel bit better. The pains are back. Hate it. My feet and ankles are the worst. I work at Sydney Airport and on my feet a lot. Don't know what to do. Thinking the only resolution is back to steroids.

    Its trying to find a balance thats hard. I dont have ANA but high inflammation markers including esr and cpk. At a loss of what to do. This has been 2 years of roller coaster. Sad thing is still cannot confirm its definately rheumatoid even though i have had so many ct scans xrays ultrasounds mri. I am in my late 40s.

    Guess nice to know on one hand there are others out there fighting the same battles day in day out. Good luck

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