Rheumatology Advance Access originally published online on April 7, 2006
Rheumatology 2006 45(10):1294-1297; doi:10.1093/rheumatology/kel123
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Safety of anti-TNF-
therapy in rheumatoid arthritis and spondylarthropathies with concurrent B or C chronic hepatitis
Rheumatology Department, University Hospital, Nice, France.
Correspondence to: Christian Roux, Hospital l'Archet 1, Rheumatology Department, 242 Avenue de Saint Antoine de Ginestiere, 06200 Nice, France. E-mail: roux101fr{at}yahoo.fr
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Abstract |
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Objective. To assess the safety of anti-tumour necrosis factor (TNF)-
therapy in patients with rheumatoid arthritis (RA) or spondylarthropathies (SA) and concurrent chronic hepatitis B or C.
Methods. 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.
Results. 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.
Conclusion. The use of anti-TNF- 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.
KEY WORDS: Rheumatoid arthritis, Spondylarthropathies, Hepatitis B virus, Hepatitis C virus, Anti-TNF- treatment
Submitted 26 December 2005;
revised version accepted 15 March 2006.
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