Safety of anti-TNF-α therapy in rheumatoid arthritis and spondylarthropathies with concurrent B or C chronic hepatitis

• Published in: Rheumatology (Oxford, England) Vol. 45; no. 10; pp. 1294 - 1297
• Main Authors: ROUX, C. H, BROCQ, O, BREUIL, V, ALBERT, C, EULLER-ZIEGLER, L
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-10-2006
• Subjects: Adalimumab; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Antirheumatic Agents - therapeutic use; Antiviral Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - virology; Biological and medical sciences; Diseases of the osteoarticular system; Drug Therapy, Combination; Etanercept; Female; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - drug therapy; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Hepatitis, Chronic - complications; Hepatitis, Chronic - drug therapy; Human viral diseases; Humans; Immunoglobulin G - therapeutic use; Infectious diseases; Inflammatory joint diseases; Infliximab; Lamivudine - therapeutic use; Male; Medical sciences; Middle Aged; Receptors, Tumor Necrosis Factor - therapeutic use; Retrospective Studies; Spondylarthropathies - drug therapy; Spondylarthropathies - virology; Transaminases - blood; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Viral diseases; Viral hepatitis; Viral Load; Toxicity; Diseases of the osteoarticular system; Orthohepadnavirus; Hepatic disease; Autoimmune disease; Inflammatory joint disease; Anti-TNF-a treatment; Viral hepatitis B; Spondylarthropathy; Hepadnaviridae; Hepatitis B virus; Tumor necrosis factor α; Viral hepatitis C; Spondylarthropathies; Immunopathology; Cytokine; Rheumatology; Infection; Virus; Chronic; Treatment; Viral disease; Rheumatoid arthritis; Digestive diseases; Flaviviridae; Hepatitis C virus; Hepacivirus
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/kel123

To assess the safety of anti-tumour necrosis factor (TNF)-alpha therapy in patients with rheumatoid arthritis (RA) or spondylarthropathies (SA) and concurrent chronic hepatitis B or C.
Records concerning 480 outpatients attending the Rheumatology Department of the University Hospital of Nice (France) for RA or SA were retrospectively reviewed for the duration of disease, treatment, serological status and biological data.
Six relevant cases were identified: two of RA with chronic hepatitis B; one of SA with chronic hepatitis B and three of RA with chronic hepatitis C. Five patients had received etanercept and one infliximab; two had been given adalimumab after an unsuccessful trial of etanercept. Patients with concurrent chronic hepatitis B were also given lamivudine. In none of the cases had changes in serum aminotransferases or viral load been reported.
The use of anti-TNF-alpha therapy (plus lamivudine in the presence of concurrent underlying hepatitis B viral infection) appeared to be safe in that it had no effect on serum aminotransferases and/or viral load. However, repeated monitoring is necessary throughout the treatment period.