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HLA associations with infliximab-induced liver injury.

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Authors
Bruno, Christopher D
Fremd, Brandon
Church, Rachel J
Daly, Ann K
Aithal, Guruprasad P
Björnsson, Einar S
Larrey, Dominique
Watkins, Paul B
Chow, Christina R
Issue Date
2020-02-06

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Citation
Bruno CD, Fremd B, Church RJ, et al. HLA associations with infliximab-induced liver injury [published online ahead of print, 2020 Feb 6]. Pharmacogenomics J. 2020;10.1038/s41397-020-0159-0. doi:10.1038/s41397-020-0159-0
Abstract
Biomarkers that are able to identify patients at risk of drug-induced liver injury (DILI) after treatment with infliximab could be important in increasing the safety of infliximab use. We performed a genetic analysis to identify possible human leukocyte antigen (HLA) associations with DILI in European Caucasian users of infliximab in a retrospective study of 16 infliximab-DILI patients and 60 matched controls. In infliximab-associated liver injury, multiple potentially causal individual HLA associations were observed, as well as possible haplotypes. The strongest associated HLA allele was HLA-B*39:01 (P = 0.001; odds ratio [OR] 43.6; 95% confidence interval [CI] 2.8-infinity), which always appeared with another associated allele C*12:03 (P = 0.032; OR 6.1; 95% CI 0.9-47.4). Other associations were observed with HLAs DQB1*02:01 (P = 0.007; OR 5.7; 95% CI 1.4-24.8), DRB1*03:01 (P = 0.012; OR 4.9; 95% CI 1.2-20.5), and B*08:01 (P = 0.048; OR 3.4; 95% CI 0.9-13.2), which also appeared together whenever present in cases. Additional associations were found with HLA-DPB1*10:01 (P = 0.042; OR 20.9; 95% CI 0.7-infinity) and HLA-DRB1*04:04 (P = 0.042; OR 20.9; 95% CI 0.7-infinity). A strong association with HLA-B*39:01 was identified as a potentially causal risk factor for infliximab-induced DILI. Future work should aim to validate this finding and explore possible mechanisms through which the biologic interacts with this particular allele.
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https://www.nature.com/articles/s41397-020-0159-0
ae974a485f413a2113503eed53cd6c53
10.1038/s41397-020-0159-0
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