Abstract

JONES, Xaviar Michael et al. Rheumatoid arthritis associated with primary biliary cholangitis under biologic treatment: Report of 4 cases and bibliography updated. Rev. argent. reumatolg. [online]. 2019, vol.30, n.2, pp.20-23. ISSN 0327-4411.

The therapeutic approach of patients with two or more autoimmune diseases is quite a challenge, especially when the treatment of one of them, can precipitate the progression of the other. Even though the association of rheumatoid arthritis (RA) and primary biliary cholangitis (PBC) is rare; when both coexist, the use of methotrexate and other hepatotoxic drugs should be used with caution. With a most widespread indication of biologic disease-modifying antirheumatic drugs (bDMARDs) some reports of patients with RA and PBC treated with etanercept, infliximab, rituximab, tocilizumab and abatacept have been published. We report a case series that includes 4 patients with RA and PBC treated with bDMARDs. This is the first report to describe two cases in which golimumab was used to control RA and the second to report patients who received adalimumab and abatacept. Three cases of patients treated with rituximab have been published to date. None of the patients of our report suffered a progression of their PBC; matter in fact, two of them showed an improvement in their biochemical parameters. PBC symptoms did not get worse in any of the patients. On the contrary, laboratory parameters improved in two of the four patients. In conclusion, according to the literature reviewed and to our findings, the use of bDMARDs could be considered in RA patients with concomitant PBC.

Keywords : Rheumatoid arthritis; primary cholangitis.