Methods for reducing drug-induced liver injury

Abstract

The present disclosure provides methods of treating a patient with infliximab or alternative therapies to reduce the risk of developing, and/or severity of, an adverse drug reaction such as drug-induced liver injury. The methods include identifying patients at risk for developing DILI by determining the presence or absence of one or more HLA alleles in the patients.

1 . A method for treating an autoimmune disease in a subject in need thereof, wherein the subject has an HLA profile comprising HLA-B*39:01, wherein the method comprises administering to the subject a therapeutic agent for the treatment of the autoimmune disease that is not infliximab. 
     
     
         2 . The method of  claim 1 , wherein the therapeutic agent for the treatment of the autoimmune disease that is not infliximab is selected from the group consisting of azathioprine, mercaptopurine, adalimumab, certolizumab, methotrexate, natalizumab, vedolizumab, ustekinumab, mesalamine, budesonide, hyoscyamine, celecoxib, hydroxychloroquin, etanercept, prednisone, cyclosporine, tocilizumab, meloxicam, leflunomide, sulfasalazine, abatacept, rituximab, golimumab, acitretin, secukinumab, apremilast, sarilumab, ixekizumab, and corticotropin. 
     
     
         3 . A method for treating an autoimmune disease in a subject in need thereof, wherein the subject has an HLA profile comprising HLA-B*39:01, wherein:
 (i) the method does not comprise administering infliximab to the subject; and   (ii) the method comprises administering to the subject a therapeutic agent selected from the group consisting of azathioprine, mercaptopurine, adalimumab, certolizumab, methotrexate, natalizumab, vedolizumab, ustekinumab, mesalamine, budesonide, hyoscyamine, celecoxib, hydroxychloroquin, etanercept, prednisone, cyclosporine, tocilizumab, meloxicam, leflunomide, sulfasalazine, abatacept, rituximab, golimumab, acitretin, secukinumab, apremilast, sarilumab, ixekizumab, and corticotropin.   
     
     
         4 . The method of  claim 3 , wherein the method reduces the risk of drug-induced liver injury (DILI) in the subject. 
     
     
         5 . The method of  claim 3 , wherein the autoimmune disease is selected from the group consisting of Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. 
     
     
         6 . The method of  claim 5 , wherein the autoimmune disease is rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis; and wherein the therapeutic agent for the treatment of the autoimmune disease that is not infliximab is selected from the group consisting of methotrexate, abatacept, adalimumab, rituximab, etanercept, certolizumab, and golimumab. 
     
     
         7 . The method of  claim 5 , wherein the autoimmune disease is Crohn's disease or ulcerative colitis, and wherein the therapeutic agent for the treatment of the autoimmune disease that is not infliximab is selected from the group consisting of adalimumab, certolizumab, natalizumab, ustekinumab, vedolizumab, azathioprine, cyclosporine, methotrexate, and mercaptopurin. 
     
     
         8 . The method of  claim 3 , wherein the method further comprises determining that the subject has an HLA profile comprising HLA-B*39:01 by obtaining or having obtained the HLA profile of the subject. 
     
     
         9 . The method of  claim 3 , wherein the method further comprises determining that the subject has an HLA profile comprising HLA-B*39:01 by obtaining a biological sample from the subject and performing a genetic assay to detect the presence of allele HLA-B*39:01 in the biological sample. 
     
     
         10 . The method of  claim 9 , wherein the genetic assay comprises one or more of a polymerase chain reaction (PCR)-based approach, a direct sequencing approach, a next generation (NGS) approach and/or a direct HLA typing test. 
     
     
         11 . The method of  claim 9 , wherein the genetic assay comprises obtaining a PCR-amplified genomic DNA sample of the biological sample from the subject, contacting under hybridizing conditions the genomic DNA with an oligonucleotide that specifically hybridizes to HLA-B*039:01, and detecting the presence of HLA-B*039:01 in the sample. 
     
     
         12 . A method of treating a condition in a subject in need of infliximab therapy, comprising: administering a therapeutically effective amount of infliximab to the subject, wherein the subject has a decreased risk of drug-induced liver injury (DILI), wherein the subject's decreased risk of DILI is associated with an absence of one or more genetic variations in the subject, wherein the subject has been tested for a presence of the one or more genetic variations with a genetic assay and has been identified as not having the one or more genetic variations, and wherein the genetic variation comprises the HLA-B*39:01 allele. 
     
     
         13 . The method of  claim 12 , wherein the condition is selected from the group consisting of Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. 
     
     
         14 . The method of  claim 12 , wherein the genetic assay comprises one or more of a polymerase chain reaction (PCR)-based approach, a direct sequencing approach, a next generation (NGS) approach and/or a direct HLA typing test. 
     
     
         15 . The method of  claim 12 , wherein the genetic assay comprises obtaining a PCR-amplified genomic DNA sample of the biological sample from the subject, contacting under hybridizing conditions the genomic DNA with an oligonucleotide that specifically hybridizes to HLA-B*39:01, and detecting the presence or absence of HLA-B*39:01 in the sample. 
     
     
         16 . The method of  claim 12 , wherein the method further comprises obtaining a biological sample from the subject and performing the genetic assay on the biological sample. 
     
     
         17 . The method of  claim 12 , wherein the therapeutically effective amount is at least 5 mg/kg infliximab. 
     
     
         18 . The method of  claim 12 , wherein the therapeutically effective amount is about 5 mg/kg to about 10 mg/kg infliximab. 
     
     
         19 . The method of  claim 12 , wherein the therapeutically effective amount is about 5 mg/kg infliximab. 
     
     
         20 - 76 . (canceled)