Predictors of hepatitis B and C virus reactivation in patients with psoriasis treated with biologic agents: a 9-year multicenter cohort study.
biologics
hepatitis B
hepatitis C
immunosuppressant
psoriasis
reactivation
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
02
10
2019
revised:
11
11
2019
accepted:
03
12
2019
pubmed:
11
12
2019
medline:
3
9
2021
entrez:
11
12
2019
Statut:
ppublish
Résumé
The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation. To determine the predictors of HBV and HCV reactivation in patients with psoriasis receiving biologics. This study screened 2060 patients with psoriasis (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 patients with psoriasis with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes). During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than in that of occult HBV (34.3% vs 3.2%, P = .001) and resolved HBV (34.3% vs 5.0%, P < .001). The multivariate analysis revealed that being hepatitis B surface antigen seropositive, being hepatitis B e-antigen seropositive, and tumor necrosis factor-α-inhibitor therapy were risk factors for HBV reactivation, whereas antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation. Observational design and a lack of a comparison group. Patients with psoriasis on biologics have a risk of HBV and HCV reactivations, particularly those who are seropositive for hepatitis B surface antigen and hepatitis B e-antigen and undergoing tumor necrosis factor-α-inhibitor therapy.
Sections du résumé
BACKGROUND
The increasing use of biologics is accompanied by a risk of hepatitis B (HBV) and C virus (HCV) reactivation.
OBJECTIVE
To determine the predictors of HBV and HCV reactivation in patients with psoriasis receiving biologics.
METHODS
This study screened 2060 patients with psoriasis (3562 treatment episodes) who were taking biologics from 2009 to 2018. There were 359 patients with psoriasis with HBV (561 treatment episodes) and 61 with HCV infection (112 treatment episodes).
RESULTS
During 8809 and 1522 person-months of follow-up, 88 treatment episodes for HBV involved HBV reactivation, and 14 episodes of HCV involved reactivation. The reactivation rate was significantly higher in treatment episodes of chronic HBV infection than in that of occult HBV (34.3% vs 3.2%, P = .001) and resolved HBV (34.3% vs 5.0%, P < .001). The multivariate analysis revealed that being hepatitis B surface antigen seropositive, being hepatitis B e-antigen seropositive, and tumor necrosis factor-α-inhibitor therapy were risk factors for HBV reactivation, whereas antiviral prophylaxis was effective in reducing the risk of HBV reactivation. No predictors were significantly associated with HCV reactivation.
LIMITATIONS
Observational design and a lack of a comparison group.
CONCLUSION
Patients with psoriasis on biologics have a risk of HBV and HCV reactivations, particularly those who are seropositive for hepatitis B surface antigen and hepatitis B e-antigen and undergoing tumor necrosis factor-α-inhibitor therapy.
Identifiants
pubmed: 31821860
pii: S0190-9622(19)33209-8
doi: 10.1016/j.jaad.2019.12.001
pii:
doi:
Substances chimiques
Biological Products
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
337-344Informations de copyright
Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest All authors completed the International Committee of Medical Journal Editors uniform disclosure form (available at www.icmje.org/coi_disclosure.pdf) and declare the following: Drs H.Y. Chiu and Hui received speaking fees from AbbVie, Novartis Pharmaceuticals Corp, Janssen-Cilag Pharmaceutica, Eli-Lilly, Kyowa Hakko Kirin Taiwan, and Pfizer Ltd, and conducted clinical trials for Eli-Lilly and Sanofi Pharmaceuticals. Dr Huang has conducted clinical trials for serving as a principal investigator for Galderma, Eli-Lilly, Novartis Pharmaceuticals Corp, and Janssen-Cilag Pharmaceutica; received honoraria for serving as an advisory board member for Pfizer Ltd, AbbVie, and Celgene; and received speaking fees from AbbVie, Eli-Lilly, and Novartis Pharmaceuticals Corp. Drs Liao and Wang have received speaking fees from AbbVie, Novartis, Eli-Lilly Pharmaceuticals Corp, Janssen-Cilag Pharmaceutica, and LEO Pharm. Dr Chiu has received speaking fees from AbbVie, Novartis Pharmaceuticals Corp, Janssen-Cilag Pharmaceutica, and Pfizer Ltd, and received honoraria for serving as a consultant for AbbVie, Novartis Pharmaceuticals Corp, and Janssen-Cilag Pharmaceutica. Dr Wu has conducted clinical trials for Novartis, Pfizer, Galderma, and Bristol-Myers Squibb, and received speaking fees from Pfizer, Novartis, AbbVie, Janssen-Cilag, Eli-Lilly, and Sanofi Pharmaceuticals. Dr Chi has received speaking fees from AbbVie Taiwan, Janssen-Cilag Taiwan, Novartis Taiwan, and Pfizer Taiwan. Dr Yang has received speaking fees from Janssen-Cilag Pharmaceutica and Pfizer Ltd and conducted clinical trials as a principle investigator for Eli-Lilly, Janssen-Cilag Pharmaceutica, and AbbVie. Dr Lee has received speaking fees from Janssen-Cilag Pharmaceutica, Sanofi, and Novartis. Dr Chen has received speaking fees from AbbVie, Novartis Pharmaceuticals Corp, LEO Pharma, Janssen-Cilag Pharmaceutica, Alliance Pharmaceuticals Ltd, Eli-Lilly, Zuellig Pharma, and Pfizer Ltd. Dr Tsai has conducted clinical trials and has received honoraria for serving as a consultant or speaking fee for Pfizer Ltd, Serono International SA (now Merck Serono International SA), UniPharma/Biogen Idec, Galderma, Celgene, Novartis Pharmaceuticals Corp, Janssen-Cilag Pharmaceutica, and AbbVie. Drs Y.M. Chiu, C.Y. Hsieh, T.Y. Hsieh, and Lai have no conflicts of interest to declare.