Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17352
Revised: April 14, 2014
Accepted: July 24, 2014
Published online: December 14, 2014
Core tip: Anti-tumour-necrosis-factor (TNF) agents appear to be safe with a low risk of causing severe liver injury. Standard guidelines for the management of anti-TNF-related liver injury are lacking. Our approach, based on evidence from literature and our centre experience, highlights the need of a multidisciplinary approach and suggests liver biopsy as a key-point in the management decision. We particularly highlight that continuation of the anti-TNF treatment is usually possible, in view of the rarity of severe liver injury and the lack of alternative medical options in case of severe active inflammatory bowel disease.