HBV and targeted synthetic (ts)DMARDs: what have we learned from bDMARDs and tsDMARDs?

Gremese, Elisa; Gasbarrini, Antonio; Ferraccioli, Gianfranco

doi:10.1136/rmdopen-2020-001171

Cited by 4 publications

(7 citation statements)

References 31 publications

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“…HBsAg-negative/anti-HBc-positive patients should be initiated prophylactic antiviral treatment (tenofovir or entecavir preferred) one week before initiating bDMARDs or tsDMARDs. Prophylactic antiviral therapy should be continued throughout treatment and stopped at least six months after tsDMARD or bDMARD discontinuation (or 12 months after rituximab completion) [ 95 ].…”

Section: Reviewmentioning

confidence: 99%

2023 Management Recommendations of Bangladesh Rheumatology Society on Pharmacological Treatment of Rheumatoid Arthritis With Synthetic and Biologic Disease-Modifying Drugs

Momen Majumder,

Hasan,

Choudhury

et al. 2024

Cureus

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Rheumatoid arthritis (RA) is the most common inflammatory polyarthritis in Bangladesh. Bangladesh Rheumatology Society (BRS) proposes these management recommendations to treat the considerable burden of RA in the resource-constrained situation based on the best current evidence combined with societal challenges and opportunities. BRS formed a task force (TF) comprising four rheumatologists. The TF searched for all available literature, including updated American College of Rheumatology (ACR), European Alliance of Associations for Rheumatology (EULAR), and Asia‐Pacific League of Associations for Rheumatology (APLAR) and several other guidelines, and systematic literature reviews until October 2023, and then a steering committee was formed, which included rheumatologists and internists. We followed the EULAR standard operating procedures to categorize levels of evidence and grading of recommendations. This recommendation has two parts -- general (diagnosis of RA, nomenclature of disease-modifying anti-rheumatic drugs [DMARDs], disease activity indices) and management portion. The TF agreed on four overarching principles and 12 recommendations. Overarching principles deal with early diagnosis and disease activity monitoring. Recommendations 1-5 discuss using glucocorticoids, NSAIDs, and conventional synthetic DMARDs (csDMARD). Recommendations 6-9 stretch the use of targeted synthetic DMARDs (tsDMARDs) and biological DMARDs (bDMARDs). The suggested DMARD therapy includes initiation with methotrexate (MTX) or another csDMARD (in case of contraindication to MTX) in the first phase and the addition of a tsDMARD in the second phase, switching to an alternative tsDMARDs or bDMARDs in the subsequent phases. The TF included the Padua prediction score for the thromboembolism risk estimation. Recommendations 10-12 cover infection screening, vaccination, and DMARD tapering. Bangladesh has a higher prevalence of RA. This recommendation will serve as a tool to treat this high burden of patients with RA scientifically and more effectively.

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Section: Reviewmentioning

confidence: 99%

2023 Management Recommendations of Bangladesh Rheumatology Society on Pharmacological Treatment of Rheumatoid Arthritis With Synthetic and Biologic Disease-Modifying Drugs

Momen Majumder,

Hasan,

Choudhury

et al. 2024

Cureus

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“…Однако недавно получены данные о том, что у HBsAg+-пациентов при лечении ЛЕФ риск HBV-р повышен [33]. В течение последних лет было показано, что, несмотря на прямое подавление фактором некроза опухоли α (ФНО-α) репликации HBV, риск HBV-р при применении ингибиторов ФНО-α является умеренным -в пять раз меньше, чем при лечении тоцилизумабом [34]. Продемонстрирована высокая частота HBV-р при лечении ритуксимабом (РТМ) и абатацептом (АБА).…”

Section: клинический случайunclassified

Reactivation of Chronic Hepatitis B in a Patient with Rheumatoid Arthritis

Гриднева¹,

Белов²,

Аронова³

2023

EPh

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The problem of hepatitis B reactivation in patients with rheumatology profile has been and remains relevant due to the widespread use of various immuno-suppressive drugs. As new drugs are introduced into practice, there is a need to clearly understand the likelihood of HBV reactivation and personalize the management of such patients. A case of reactivation of HBV infection in a patient treated with upadacitinib and prophylactic with entecavir is presented. This review briefly summarizes the latest data on the mechanisms of HBV reactivation and the relative frequency of HBV reactivation, associated with various antirheumatic drugs

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“…Наличие способной к репликации ДНК HBV и длительный период полураспада гепатоцитов обусловливают то, что однажды начавшаяся инфекция HBV может продолжаться всю жизнь, даже при достижении эффективного иммунного контроля. В этих случаях отсутствие HBsAg уравновешивается наличием НВсAg и положительным иммунологическим ответом против него -анти-HBc [22]. Обнаружение анти-HBc в качестве суррогатного маркера скрHBV полезно, когда тест на ДНК HBV недоступен или есть подозрение на интермиттирующую виремию.…”

Section: фазы хронической Hbv-инфекции скрытая Hbv-инфекцияunclassified

“…Обнаружение анти-HBc в качестве суррогатного маркера скрHBV полезно, когда тест на ДНК HBV недоступен или есть подозрение на интермиттирующую виремию. Следует помнить, что отрицательный результат анти-HBc еще не означает отсутствие инфекции (такая ситуация трактуется как полностью серонегативная HBVинфекция) [22].…”

Section: фазы хронической Hbv-инфекции скрытая Hbv-инфекцияunclassified

“…Кроме того, подгруппа людей со скрHBV часто инфицирована вариантами HBVS, несущими мутации в гене S (S-ускользающие мутации), что приводит к продукции модифицированного HBsAg, который не распознается некоторыми коммерческими реактивами. Уровни циркулирующей ДНК HBV у этих людей могут быть сопоставимы с таковыми у HBsAgположительных лиц [22]. Препараты для лечения ХГB Клиническими рекомендациями по лечению ХГВ предусмотрены и наиболее часто применяются препараты интерферона альфа, нуклеозидный ингибитор обратной транскриптазы ламивудин, как аналог нуклеозида гуанозина энтекавир и нуклеотидный ингибитор обратной транскриптазы тенофовир.…”

Section: фазы хронической Hbv-инфекции скрытая Hbv-инфекцияunclassified

See 1 more Smart Citation

Chronic viral hepatitis B and rheumatic diseases: Modern view on problem

Гриднева¹,

Белов²,

Аронова³

2022

Medicinskij alfavit

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Infection caused by hepatitis B virus (HBV) is one of the most common hemocontact infections. The special life cycle of the hepatitis B virus, the course of infection, often hidden, and the high risk of developing life-threatening conditions, such as fulminant hepatitis and hepatocellular carcinoma, make it necessary to exercise special caution when choosing therapeutic tactics for rheumatological patients, since the vast majority of drugs used in rheumatological practice have immunosuppressive properties. This review updates information on the risks of reactivation of HBV infection in the treatment of currently used antirheumatic drugs, considers difficult to curate variants of chronic hepatitis B with delta agent and extrahepatic manifestations, in particular, thrombocytopenia. The most systematic and consistent approach to ranking the risk of reactivation of HBV infection (low [less than 1 %], moderate [1–10 %] and high [higher than 10 %]), in accordance with the serological status of the patient, as well as the type and duration of immunosuppressive treatment used, is proposed by the American Gastroenterological Association. The authors have attempted to unify the current literature data according to this classification.

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HBV and targeted synthetic (ts)DMARDs: what have we learned from bDMARDs and tsDMARDs?

Cited by 4 publications

References 31 publications

2023 Management Recommendations of Bangladesh Rheumatology Society on Pharmacological Treatment of Rheumatoid Arthritis With Synthetic and Biologic Disease-Modifying Drugs

2023 Management Recommendations of Bangladesh Rheumatology Society on Pharmacological Treatment of Rheumatoid Arthritis With Synthetic and Biologic Disease-Modifying Drugs

Reactivation of Chronic Hepatitis B in a Patient with Rheumatoid Arthritis

Chronic viral hepatitis B and rheumatic diseases: Modern view on problem

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