{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:56:09Z","timestamp":1767797769178,"version":"3.49.0"},"reference-count":41,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Patients with rheumatic immune-mediated inflammatory diseases (R-IMID) require latent tuberculosis infection screening and, in case of positivity, chemoprophylaxis. Isoniazid INH remains the standard regimen, but hepatotoxicity is an underrecognized concern. To describe the characteristics of R-IMID patients developing hepatotoxicity during INH therapy and identify potential risk factors through clinical analysis and literature review. Methods: Retrospective study of 64 R-IMID who developed hepatotoxicity with INH. Mean age was 53.4 \u00b1 10.5 years; 70.3% female. Diagnoses included spondyloarthritis\/psoriatic arthritis (56.3%), rheumatoid arthritis (32.8%), systemic sclerosis (4.7%), connective tissue diseases (4.7%), and other IMIDs (3.2%). All patients showed \u2265 2 \u00d7 upper limit of normality (ULN) liver enzyme elevation, 34.4% \u2265 3 ULN, 20.3% \u2265 4 ULN. Literature review (19 studies) revealed INH-related hepatotoxicity rates of 1\u201341%, exacerbated by concurrent methotrexate, sulfasalazine, TNF inhibitors, and prior drug-induced liver injury. Results: Hepatotoxicity was frequent when INH was combined with other hepatotoxic drugs, especially methotrexate. Conclusions: INH prophylaxis in R-IMID patients carries substantial hepatotoxic risk. Careful hepatic monitoring and individualized risk stratification are essential to prevent liver injury in immunosuppressed populations.<\/jats:p>","DOI":"10.3390\/jcm15020432","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:49:46Z","timestamp":1767707386000},"page":"432","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatotoxicity Risk of Isoniazid in Patients with Autoimmune Rheumatic Diseases and Prior Liver Injury Due to Disease-Modifying Antirheumatic Drugs: A Single-Center Experience and Literature Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Joy Selene","family":"Osorio-Ch\u00e1vez","sequence":"first","affiliation":[{"name":"Pneumology, Hospital Universitario Marqu\u00e9s de Valdecilla, Valdecilla Santander Research Institute, Immunopathology Group (IDIVAL), 39008 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Portilla Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario Marqu\u00e9s de Valdecilla, Valdecilla Santander Research Institute, Immunopathology Group (IDIVAL), Avda. Valdecilla s\/n, 39008 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0197-5267","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Ferraz-Amaro","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7748-853X","authenticated-orcid":false,"given":"Santos","family":"Casta\u00f1eda","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3682-0142","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Cifri\u00e1n Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Pneumology, Hospital Universitario Marqu\u00e9s de Valdecilla, Valdecilla Santander Research Institute, Immunopathology Group (IDIVAL), 39008 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-2285","authenticated-orcid":false,"given":"Ricardo","family":"Blanco Alonso","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario Marqu\u00e9s de Valdecilla, Valdecilla Santander Research Institute, Immunopathology Group (IDIVAL), Avda. Valdecilla s\/n, 39008 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022). WHO Unified Guidelines on Tuberculosis: Preventive Treatment of Tuberculosis, Organizaci\u00f3n Panamericana de la Salud."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.14745\/ccdr.v43i34a01","article-title":"Latent tuberculosis infection: An overview","volume":"43","author":"Kiazyk","year":"2017","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Osorio-Ch\u00e1vez, J.S., Mart\u00ednez-L\u00f3pez, D., \u00c1lvarez-Reguera, C., Portilla, V., Cifri\u00e1n, J.M., Casta\u00f1eda, S., Ferraz-Amaro, I., and Blanco, R. (2024). Epidemiology of latent tuberculosis in rheumatic immune-mediated inflammatory diseases: Study of 1117 patients and descriptive literature review. J. Clin. 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