Treatment with etanercept in six patients with chronic hepatitis C infection and systemic autoimmune diseases.
OBJECTIVE
To describe the clinical and immunologic features of 6 patients with rheumatic disease and Hepatitis C Virus (HCV) chronic infection, treated with anti-TNF alpha drugs.


METHODS
Six patients, with repeated positive serology for HCV infection, were affected by Rheumatoid arthritis (RA) (4 cases), Psoriatic Arthritis (PsA) and Polymyositis in one case each. They started anti-TNFalpha treatment (Etanercept), due to a previous failure of combination of different immunosuppressants (Methotrexate, Sulfasalazine, Cyclosporine, Hydroxychloroquine).


RESULTS
Patients (3 female and 3 males) showed a mean age at disease onset of 50.6 years (SD 14.5) and a mean disease duration of 12.5 years (SD: 8.8). Etanercept (dosage of 50 mg weekly) was continued for a median period of 14 months. Patients affected by RA and PsA achieved a good clinical response, with a significant reduction of DAS28 during treatment (p: 0.0001). No patient received any specific therapy for HCV infection. Elevated HCV-RNA titres were recorded in 5 cases at start of Etanercept. No significant increase was observed during anti-TNF alpha treatment. No cases of hepatic failure were recorded.


CONCLUSIONS
Anti-TNF alpha therapy showed to be effective, safe and well tolerated in the setting of HCV infection.
Cavazzana
I
I
Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy. ilariacava@virgilio.it
Ceribelli
A
A
Cattaneo
R
R
Franceschini
F
F
D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000068800:Etanercept; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept