Analysis of risk factors of liver injury after intravenous methylprednisolone in neuromyelitis optica spectrum disorders

Abstract

Objective To investigate the risk factors of liver injury in patients with neuromyelitis optica spectrum disorders (NMOSDs) after intravenous methylprednisolone (IVMP). Methods A total of 195 patients with NMOSDs who received IVMP in Beijing Tongren Hospital, Capital Medical University from January 2017 to December 2021 were enrolled. The causal relationship between IVMP and liver injury was evaluated according to Roussel Uclaf Causality Assessment Method (RUCAM). Univariate and multivariate stepwise Logistic regression analysis were used to screen the risk factors of IVMP related liver injury. Results Within 14 d after IVMP therapy, 32.31% (63/195) patients developed liver injury [serum alanine aminotransferase (ALT)＞40 U/L, RUCAM score≥3]. Severe injury (ALT＞120 U/L) accounted for 15.87% (10/63) and mild injury 84.13% (53/63). Logistic regression analysis showed age≥50 years old (OR=0.969, 95%CI: 0.945-0.993; P=0.011), previous use of immunosuppressants (OR=3.543, 95%CI: 1.579-7.949; P=0.002) and history of IVMP related liver injury (OR=17.043, 95%CI: 3.400-85.423; P=0.000) were the main risk factors for IVMP related liver injury. Conclusions The main IVMP related liver injury is mild injury. NMOSDs patients aged≥50 years old, previous use of immunosuppressants and history of IVMP related liver injury are more prone to liver injury when treated with IVMP again.

doi：10.3969/j.issn.1672⁃6731.2022.09.004