Use of anti-tumor necrosis factor alpha therapy in patients with concurrent rheumatoid arthritis and hepatitis B or hepatitis C: a retrospective analysis of 32 patients.
The safety of tumor necrosis factor-alpha (TNF-α) inhibitors in the setting of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections is controversial. The use of anti-TNF-α in rheumatoid arthritis (RA) is associated with an increased risk of hepatitis re-activation. This paper reports experience of using etanercept and adalimumab in 32 patients with RA and previous HBV or HCV infection. No cases of HBV or HCV reactivation were seen. In just over a fifth of patients, increased transaminases levels were seen, which were associated with concomitant use of disease-modifying antirheumatic drugs, isoniazid prophylaxis, or alcohol abuse. In our experience, anti-TNF-α therapy appears to be safe in RA patients with previous HBV or HCV infection, but monitoring remains necessary in these patients.
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi,", University of Rome Tor Vergata, Roma, 00133, Italy.
Eleonora
E
Ballanti
Paola
P
Conigliaro
Maria Sole
MS
Chimenti
Barbara
B
Kroegler
Gioia
G
Di Muzio
Maria Domenica
MD
Guarino
Paola
P
Triggianese
Gianfranco
G
Gigliucci
Lucia
L
Novelli
Carmen
C
Barbato
Roberto
R
Perricone
D000068879:Adalimumab; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D001219:Aspartate Aminotransferases / Q000097:blood; D015897:Comorbidity; D000068800:Etanercept; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006526:Hepatitis C / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000068879:Adalimumab; D000068800:Etanercept
anti-TNF; hepatitis B; hepatitis C; rheumatoid arthritis