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Rheumatology Advance Access published online on May 23, 2006
Rheumatology, doi:10.1093/rheumatology/kel191
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received April 12, 2006
Accepted April 25, 2006

Concise Report

Etanercept treatment for three months is safe in patients with rheumatological manifestations associated with hepatitis C virus

H. Marotte 1, E. Fontanges 1, F. Bailly 2, F. Zoulim 2, C. Trepo 2, and P. Miossec 1 *

1 Clinical Immunology Unit, Department of Immunology and Department of Rheumatology, and Hospices Civils de Lyon-bioMérieux Research Unit on Rheumatoid Arthritis, Edouard Herriot Hospital, France
2 Hepatology Unit, Hotel-Dieu, Lyon, France

* To whom correspondence should be addressed.
P. Miossec, E-mail: miossec{at}univ-lyon1.fr


  Abstract

Objective. The treatment of the rheumatological manifestations associated with hepatitis C virus (HCV) remains difficult. To examine the safety of anti-tumour necerosis factor-{alpha} treatment, nine patients having rheumatological manifestations associated with HCV were treated with etanercept 25 mg twice a week for 3 months.

Methods. Five patients had a positive viral load at study entry (Group I), four were negative (Group II). Clinical data recorded were: disease duration, painful and swollen joint count, patient global and physician global assessment, the number of 18 specified fibromyalgia tender points and the Health Assessment Questionnaire score. Laboratory studies included checking for the presence of cryoglobulinaemia and transaminase levels. Quantitative HCV viral RNA was performed by real-time polymerase chain reaction (PCR).

Results. At 3 months, no patient was found to have evidence of increased hepatic inflammation based on serial serum transaminase levels. In the five patients from Group I with detectable HCV RNA, no significant viral load increase was observed. No reactivation was observed in the four patients from Group II with undetectable HCV RNA. The effect on the clinical rheumatological manifestations was more heterogeneous but appears to be lower than that observed in rheumatoid arthritis.

Conclusion. In this phase II open short-term study, etanercept appeared to be safe in patients with articular manifestations associated with HCV.

Keywords: Rheumatological manifestations; Hepatitis C; Etanercept; Safety.
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