Safety of Tocilizumab in Rheumatoid Arthritis Patients with Resolved Hepatitis B Virus Infection: Data from Real-World Experience
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To investigate whether the use of IL-6 receptor antagonist (tocilizumab) might be associated with hepatitis B virus (HBV) reactivationin rheumatoid arthritis (RA) patients, particularly in those with resolved HBV infection [HBV surface antigen (HBsAg) negativeand antibody to HBV core antigen (anti-HBc) positive, serologically]. HBsAg, anti-HBc, antibody to HBsAg (anti-HBs), andHBV DNA titers were measured in RA patients who had continuously received tocilizumab for more than 3 months. Patients weredivided into two groups according to the presence of anti-HBc. Clinical and laboratory data, in addition to medications administeredalong with tocilizumab during the treatment duration with tocilizumab, were compared between the two groups. HBV reactivationwas defined as the presence of HBV DNA in sera, and alterations in HBsAg, anti-HBc, and anti-HBs titers according tothe use of tocilizumab were also evaluated. Fifteen of 39 patients (38.5%) had anti-HBc positivity, while 24 patients (61.5%) didnot. There were no differences in demographic data, serologic classification, and variables related to tocilizumab between the anti-HBc-positive and -negative groups. Comparison of the medications administered along with tocilizumab treatment revealedno meaningful differences. None of the patients experienced reactivation of HBV. In addition, in 15 patients with resolved HBVinfection, no alterations in HBsAg, anti-HBc, and anti-HBs titers were observed with the use of tocilizumab. Tocilizumab may beapplied to RA patients safely with few concerns for HBV reactivation, particularly in those with resolved HBV infection.
Abstract
To investigate whether the use of IL-6 receptor antagonist (tocilizumab) might be associated with hepatitis B virus (HBV) reactivationin rheumatoid arthritis (RA) patients, particularly in those with resolved HBV infection [HBV surface antigen (HBsAg) negativeand antibody to HBV core antigen (anti-HBc) positive, serologically]. HBsAg, anti-HBc, antibody to HBsAg (anti-HBs), andHBV DNA titers were measured in RA patients who had continuously received tocilizumab for more than 3 months. Patients weredivided into two groups according to the presence of anti-HBc. Clinical and laboratory data, in addition to medications administeredalong with tocilizumab during the treatment duration with tocilizumab, were compared between the two groups. HBV reactivationwas defined as the presence of HBV DNA in sera, and alterations in HBsAg, anti-HBc, and anti-HBs titers according tothe use of tocilizumab were also evaluated. Fifteen of 39 patients (38.5%) had anti-HBc positivity, while 24 patients (61.5%) didnot. There were no differences in demographic data, serologic classification, and variables related to tocilizumab between the anti-HBc-positive and -negative groups. Comparison of the medications administered along with tocilizumab treatment revealedno meaningful differences. None of the patients experienced reactivation of HBV. In addition, in 15 patients with resolved HBVinfection, no alterations in HBsAg, anti-HBc, and anti-HBs titers were observed with the use of tocilizumab. Tocilizumab may beapplied to RA patients safely with few concerns for HBV reactivation, particularly in those with resolved HBV infection.
참고문헌 (20)
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