HBV Reactivation Risk with DMARDs Use
The rate of hepatitis B (HBV) reactivation was low in patients with resolved HBV who received disease-modifying antirheumatic drugs (DMARDs) for inflammatory arthritis, according to a systematic review and meta-analysis published online in Arthritis Care & Research (doi: 10.1002/acr.23346).
The meta-analysis was based on 25 studies that included 1032 patients with resolved HBV and 259 patients with chronic HBV.
Researchers found the overall pooled rate of HBV reactivation in resolved patients was just 1.6%. Rates were similar whether the resolved patients received tumor necrosis factor (TNF) inhibitors (1.4%), non-TNF biologics (6.1%), or nonbiologic DMARDs (1.7%), researchers reported.
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Patients with chronic HBV receiving DMARDS, meanwhile, had moderate rates of HBV reactivation. However, the meta-analysis found lower reactivation rates in patient with chronic HBV who took antiviral prophylaxis (9%), compared with patients who did not (14.6%).
Reactivation in patients with chronic HBV who did not take antiviral prophylaxis was reported in 7 studies, while HBV reactivation among patients with chronic HBV who took antiviral prophylaxis was also reported in 7 studies
Additionally, a 4.4% HBV reactivation rate in patients with chronic HBV receiving TNF inhibitors and antiviral prophylaxis, compared with a 15.6% reactivation rate without antiviral prophylaxis was reported. With nonbiologic DMARDS, reactivation rates were similar: 27.1% with antiviral prophylaxis and 22.4% without antiviral prophylaxis.
—Jolynn Tumolo
