Viral hepatitis screening guideline before biological drug use in rheumatic patients

KARADAĞ Ö., Kasifoglu T., Ozer B., Kaymakoglu S., KUS Y., Inanc M., ...Daha Fazla

EUROPEAN JOURNAL OF RHEUMATOLOGY, cilt.3, sa.1, ss.25-28, 2016 (ESCI) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 3 Sayı: 1
  • Basım Tarihi: 2016
  • Doi Numarası: 10.5152/eurjrheum.2015.150072
  • Dergi Adı: EUROPEAN JOURNAL OF RHEUMATOLOGY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.25-28
  • Anahtar Kelimeler: Viral hepatitis, biologic drugs, rheumatic patients, B-VIRUS INFECTION, REACTIVATION, PREVENTION, PREVALENCE, INHIBITORS, THERAPY
  • İstanbul Üniversitesi Adresli: Evet

Özet

Biological drugs (tumor necrosis factor inhibitors, rituximab, tocilizumab, abatacept, and tofacitinib) are important treatment alternatives in rheumatology, particularly for resistant patients. However, they may cause hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation; for instance, HBV reactivation may occur in a patient who is an inactive hepatitis B surface antigen (HBsAg) carrier or who has resolved HBV infection. Therefore, the screening of patients before biological treatment and the application of a prophylactic treatment, particularly with respect to latent HBV infections, are recommended when necessary. This guideline covers pre-treatment screening and follow-up recommendations, if required, with respect to viral hepatitides in rheumatology patients who are planned to be given biological drugs. Although this guideline is prepared for biological disease-modifying antirheumatic drugs (DMARDs), it is recommended to be used also for target-oriented DMARDS and medium-high dose corticosteroids (>7.5 mg prednisolone/day equivalent). It should be considered that the reactivation risk is higher when more than one immunosuppressive drug is used.