Use of biological disease-modifying anti-rheumatic drugs in patients with concurrent rheumatic disease and hepatitis B
Internal Medicine Journal, 05/30/2012
King LK et al. – Hepatitis B virus (HBV) reactivation may result in serious consequences, including death. Tuberculosis screening prior to Biological disease–modifying anti–rheumatic drugs (bDMARDs) treatment is already standard practice, as is HBV screening for patients undergoing cancer chemotherapy. Implementing HBV screening for all patients prior to bDMARD treatment can identify patients with chronic HBV who may require antiviral therapy.Methods
- A literature search was undertaken to identify all reports of patients with inflammatory arthritides and concurrent HBV infection being treated with bDMARDs.
- Forty–three patients with HBV infection were identified, of whom eight patients developed HBV reactivation after exposure to bDMARDs.
- Of the patients who experienced reactivation, two had unknown infection that surfaced during bDMARD therapy.
- Patients who experienced reactivation were promptly treated with antiviral therapy and saw clinical improvement.
- There are no long–term data on these patients.