Effect of therapy on the hepatobiliary system in patients with rheumatoid arthritis impact of antirheumatic therapy on the hepatobiliary system in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune systemic disease, in the development and progression of which significant manifestations of internal organ and system pathology are observed, with gastrointestinal tract lesions accounting for 11%.

The aim of the study: comprehensive examination of the state of the hepatobiliary system (HBS) in patients with RA depending on the treatment regimen.

Material and methods. 35 patients with predominantly early manifestations of RA were under observation. All were either newly started on anti-inflammatory therapy, or received it irregularly. 12 patients received only non-steroidal anti-inflammatory drugs (NSAIDs), 13 – NSAIDs in combination with «disease-modifying antirheumatic drugs» (DMARDs) (methotrexate, hydroxychloroquine), and 10 patients underwent complex treatment – NSAIDs+ hydroxychloroquine +oral glucocorticoids.

Results and discussion. The fact that this functional impairment is due to the active rheumatoid process, and not only to toxic-dystrophic changes in the liver and gallbladder occurring in weakened, long-suffering patients taking numerous medications, is evidenced by the change in the activity of the main biochemical syndromes (especially the mesenchymal-inflammatory and cytolytic syndromes) as the duration of the disease increases, with a more severe course of RA, in the presence of systemic manifestations, increased disease activity, and a tendency for indicators to normalize as a result of complex therapy. Supporting this assumption are the results of a study of the functional state of the hepatobiliary system in relatively newly diagnosed and untreated or inadequately treated patients.

Conclusions. Treatment of rheumatoid arthritis with «disease-modifying antirheumatic drugs» and glucocorticosteroids has a positive effect on the functional state of the liver in terms of correcting biochemical syndromes: cytolysis, cholestasis, hepatocellular failure, and mesenchymalinflammatory, which are markers of chronic hepatitis.

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