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Biologics study: HBV reactivation remains rare, prophylactic antivirals may not be needed
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In a study of German patients with rheumatic diseases treated with biologics, the incidence of reactivation of the hepatitis B virus was uncommon, according to recently presented data.
Using an electronic database of 10,019 patients treated in a rheumatology outpatient clinic between April 2008 and May 2015, researchers identified 1,107 patients screened for hepatitis B virus (HBV). The database included 663 patients with rheumatoid arthritis (RA), 140 patients with spondyloarthritis, 113 patients with psoriatic arthritis (PsA), 54 patients with vasculitis, 50 patients with connective tissue diseases or myositis, and 87 patients with a rheumatic disease defined as other.
Investigators found hepatitis B core antibodies in 5% of patients (n = 59), and one patient had an active HBV infection. Two of the 59 patients, including the patient with an active infection, received prophylactic antiviral treatment. No HBV reactivations were apparent, and no new incidents of liver failure occurred. However, investigators noted traces of HBV DNA in one patient who received infliximab (Remicade, Janssen) and one patient of the 378 patients who received rituximab (Rituxan, Genentech/Biogen Idec). HBV DNA was not detected in either patient following antiviral treatment.
“HBV reactivation during anti-rheumatic therapy with biologics is a relatively rare event in German patients,” the researchers wrote. “While both screening for prior or chronic HBV infection and close monitoring of affected patients is mandatory, prophylactic antiviral treatment does not seem to be necessary in every detected case of prior HBV infection.” - by Shirley Pulawski
Reference:
Scharbatke EC, et al. Paper #1513. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.
Disclosures: Scharbatke reports financial arrangements with Chugai Pharma, AbbVie, Baxter and Roche. Please see the full study for a list of all other authors’ relevant financial disclosures.