HBV Reactivation Is Low Among Patients With Arthritis

Hepatitis B (HBV) reactivation rates are low among patients with resolved HBV infection and inflammatory arthritis who are taking disease-modifying anti-rheumatic drugs (DMARDs), according to a recent study.

In their systematic review, the researchers searched for studies published on PubMed, Medline, and EMBASED from inception through December 31, 2015. They selected 25 studies that documented HBV reactivation among participants with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis and resolved or chronic HBV infection. All participants were receiving TNF inhibitors, non-TNF biologic, or non-biologic DMARDs. Study data and quality were assessed by 4 independent reviewers, and the pooled HBV reactivation rates were calculated.
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Among patients with resolved HBV, the overall pooled rate of HBV reactivation was 1.6%. The rates were similar between patients with resolved HBV taking TNF inhibitors, non-TNF biologics, and non-biologic DMARDs.

In addition, the HBV reactivation rate was lower among patients with chronic HBV who were receiving antiviral prophylaxis compared with those who were not taking antiviral prophylaxis.

“We found the hepatitis B reactivation rate in inflammatory arthritis patients receiving DMARDs was low in resolved patients and moderate in chronic HBV infection patients,” the researchers concluded. “Further, lower rates were observed in chronic HBV infection patients using antiviral prophylaxis.”

—Melissa Weiss

Reference:

Lin TC, Yoshida K, Tedeschi SK, de Abreu MM, Hashemi N, Solomon DH. Risk of hepatitis B reactivation in inflammatory arthritis patients receiving disease modifying anti-rheumatic drugs (DMARDs): a systematic review and meta-analysis [published online August 22, 2017]. Arthritis Care Res. doi:10.1002/acr.23346.