ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1322

Use of Biologics in Arthritis Patients with Hepatitis B and C ‏: A Multicentral Retrospective Case Series

Sultana Abdulaziz1, Hessein Halabi2, Mohammed Omair3, Suzan Attar4, Mohammed Shabrawishi5, Abdulwahab Neyazi6, Haneen Alnazzawi7, Noha Meraiani8 and Hani Almoallim9, 1Dept of Medicine/Unit of Rheumatology, King Fahad Hospital, Jeddah, Saudi Arabia, 2Department of Medicine, King Faisal Specialist Hospital,, Jeddah, Saudi Arabia, 3Dept of Medicine, Div of Rheumatology, King Saud University, Riyadh, Saudi Arabia, 4Internal Medicine, FRCPC, ABIM, Professor in Medicine, Jeddah, Saudi Arabia, 5Department of Medicine, King Faisal Specialist Hospital, Jeddah, Saudi Arabia, 6Department of Medicine, King Abdullah Medical City, Jeddah, Saudi Arabia, 7King Faisal Specialist Hospital, JEDDAH, Saudi Arabia, 8Department of Medicine, National Guard Hospital, JEDDAH, Saudi Arabia, 9Department of Medicine, Umm Alqura University, Makkah, Saudi Arabia, Makkah, Saudi Arabia

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Monday, November 14, 2016

Title: Infection-related Rheumatic Disease - Poster

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Use of biologics in arthritis patients with Hepatitis B and C ‏: a multicentral retrospective case series  

Abstract

Background/Purpose: Reactivation of viral hepatitis B (HBV) and C (HCV) has been reported in various case reports in arthritis patients on biological therapy. The objective of the   study is to describe clinical characteristics and outcomes of arthritis patients with HBV or HCV treated with biological therapy‏.

Methods: This is a retrospective case series including 4 centers.

Results: Total of 20 arthritis patients with HBV and HCV on biological therapy were identified: 10 cases had (HBV) and 10 cases had (HCV) infection. In the HBV cohort the mean age was 51 (34-85) years, 80% were females. Most patients had Rheumatoid Arthritis (RA) 8(80%), 1 patient had RA/ Systemic lupus erythematosis (SLE) and 1 had HIV related arthritis.A total of  70% were inactive HBsAg carrier and the 3 had chronic hepatitis B. Prophylactic antiviral therapy was given in 9 patients with HBV cases: Entecavir (ETV) 7 , lamivudine and (ETV) 1 and tenofovir 1. The biologics used were Adalimumab (ADA), tociluzumab (TOC), rituximab (RIT) and etarnercept (ETA). There were 2 cases with chronic HBV had reactivation with no elevation of the transaminases.

The mean age in Hepatitis C (HCV) cohort was 54 (23-79) years, all were female RA patients. 5 had detectable HCV RNA before start of biologics. Antiviral treatment was given in 9 (90 %) patients of the hepatitis C cohort: pegylated interferone plus ribavarin (PEG-RIB) 8, PEG-RIB and sofosbuvir plus ribavirin (SOF-RIB) 1pat. The biologics that were used: (ETA, ADA, TOC, RIT, abatacept (ABA) and infliximab (INF). There were 3 patients found to have elevated HCV RNA with elevation of transaminases during followup on biologics meeting criteria for hepatitis C reactivation. All three cases were genotype 4. One of the patients with HCV reactivation  was started on SOF-RIB that showed undectable HCV RNA on follow-up.

Conclusion: We report a successful and safe use of biological therapy in patients with arthritis infected with HBV or HCV. Frequent monitoring is essential to detect reactivation that might occur.

Disclosure: S. Abdulaziz, None; H. Halabi, None; M. Omair, None; S. Attar, None; M. Shabrawishi, None; A. Neyazi, None; H. Alnazzawi, None; N. Meraiani, None; H. Almoallim, None.

To cite this abstract in AMA style:

Abdulaziz S, Halabi H, Omair M, Attar S, Shabrawishi M, Neyazi A, Alnazzawi H, Meraiani N, Almoallim H. Use of Biologics in Arthritis Patients with Hepatitis B and C ‏: A Multicentral Retrospective Case Series [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/use-of-biologics-in-arthritis-patients-with-hepatitis-b-and-c-%e2%80%8f-a-multicentral-retrospective-case-series/. Accessed .

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