Journal of the American Academy of Dermatology · 2025
Comparative risk of reactivation of hepatitis B and C after treatment with biologics and targeted synthetic DMARDs in psoriasis and psoriatic arthritis: A 15-year multicenter cohort study.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Chiu Hsien-Yi, Hsu Che-Chia, Tsai Tsen-Fang, Lai Kuo-Lung, Hung Sung-Jen, Wu Nan-Lin, Wei Kai Che, Chiu Tsu-Man, Hsu Shao-Hsuan, Lan Ting-Yuan, Lee Chaw-Ning, Chiu Ying-Ming, Hui Rosaline Chung-Yee, Chi Ching-Chi, Chen Chun-Bing, Yang Chao-Chun, Tseng I-Lun, Huang Yu-Huei
Аннотация
BACKGROUND: The relative risks of HBV reactivation (HBVr) and HCV reactivation (HCVr) associated with different immunosuppressant agents in psoriasis and psoriatic arthritis are unknown.
OBJECTIVE: We assessed the comparative risks of HBVr and HCVr for patients treated with biologics and targeted synthetic disease-modifying antirheumatic drugs.
METHODS: We screened 5,527 treatment episodes (TEs) with available HBV and HCV serology data from 3197 patients who received biologics or targeted synthetic disease-modifying antirheumatic drugs; 1525 eligible TEs (1343 HBV TEs; 182 HCV TEs) were included.
RESULTS: HBVr and HCVr occurred in 143 (10.6%) and 18 (9.9%) of TEs during 2104.5 and 271.2 person-years of follow-up, respectively. The risks of HBVr and HCVr were highest for tumor necrosis factor-α inhibitors, followed by interleukin-12/23 inhibitor (IL-12/23i), IL-17i, and IL-23i. Analysis revealed drug class (tumor necrosis factor-α inhibitors), hepatitis B surface antigen-positivity, hepatitis B e-antigen-positivity, concomitant use of immunosuppressants, and absence of antiviral prophylaxis were significantly associated with HBVr; a higher baseline viral load and drug class (tumor necrosis factor-α inhibitors) were associated with HCVr.
LIMITATIONS: Observational design and nonrandom treatment allocation.
CONCLUSIONS: The differential risks of HBVr and HCVr should be considered when selecting targeted therapies in psoriasis and psoriatic arthritis, particularly for patients with risk factors for viral reactivation.
OBJECTIVE: We assessed the comparative risks of HBVr and HCVr for patients treated with biologics and targeted synthetic disease-modifying antirheumatic drugs.
METHODS: We screened 5,527 treatment episodes (TEs) with available HBV and HCV serology data from 3197 patients who received biologics or targeted synthetic disease-modifying antirheumatic drugs; 1525 eligible TEs (1343 HBV TEs; 182 HCV TEs) were included.
RESULTS: HBVr and HCVr occurred in 143 (10.6%) and 18 (9.9%) of TEs during 2104.5 and 271.2 person-years of follow-up, respectively. The risks of HBVr and HCVr were highest for tumor necrosis factor-α inhibitors, followed by interleukin-12/23 inhibitor (IL-12/23i), IL-17i, and IL-23i. Analysis revealed drug class (tumor necrosis factor-α inhibitors), hepatitis B surface antigen-positivity, hepatitis B e-antigen-positivity, concomitant use of immunosuppressants, and absence of antiviral prophylaxis were significantly associated with HBVr; a higher baseline viral load and drug class (tumor necrosis factor-α inhibitors) were associated with HCVr.
LIMITATIONS: Observational design and nonrandom treatment allocation.
CONCLUSIONS: The differential risks of HBVr and HCVr should be considered when selecting targeted therapies in psoriasis and psoriatic arthritis, particularly for patients with risk factors for viral reactivation.