Risk of Hepatitis B Reactivation in Patients with Psoriasis on Ustekinumab

Ting, Sze-Wen; Chen, Yi-Cheng; Huang, Yu‐Huei

doi:10.1007/s40261-018-0671-z

Cited by 51 publications

(30 citation statements)

References 45 publications

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“…It is recommended to treat patients for active or latent TB prior to the onset of therapy. Limited data show that ustekinumab treatment in patients with active or latent hepatitis B virus or hepatitis C virus is safe and effective and is not associated with an increased rate of reactivation [114][115][116].…”

Section: Discussionmentioning

confidence: 99%

Use of IL-23 Inhibitors for the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review

2020

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Psoriasis is a common inflammatory skin disease with multiple comorbidities, including psoriatic arthritis and coronary artery disease, that can severely impact an individual’s quality of life and daily functioning. In recent years, enhanced understanding of the pathogenesis of psoriasis, especially the role of T helper 17 cells, has resulted in the development of new classes of biologic drugs targeting modulators along its disease pathway. Among these, inhibitors of interleukin-23 (e.g., ustekinumab, guselkumab, tildrakizumab, and risankizumab) have emerged as safe and effective options for the treatment of moderate-to-severe plaque psoriasis; ustekinumab and guselkumab have additionally been approved to treat psoriatic arthritis. Selective interleukin-23 inhibitors require less frequent dosing than interleukin-17 inhibitors and may possess a more favorable risk profile without an increased risk of candidiasis or inflammatory bowel disease. Overall, these highly effective medications are contributing to a rising standard for psoriasis outcomes through resolution of skin lesions and joint manifestations and improvement of patient quality of life.

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Section: Discussionmentioning

confidence: 99%

Use of IL-23 Inhibitors for the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review

2020

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“…Binds to and neutralizes interleukin 12 and 23, which may be required for T cell activation and/ or proliferation High (B) [135][136][137] Moderate (B) 137 Calcineurin inhibitors Ciclosporin, tacrolimus Solid organ transplantation, rheumatoid arthritis, psoriasis, aplastic anemia Inhibit calcineurin which is required for signal transduction of T cell activation, and suppress transcription of IL-2 which is required for T cell proliferation Low (C) 138 139 Low (C) 140 Mammalian target of rapamycin (mTOR) inhibitors Everolimus Breast cancer, renal cell carcinoma, neuroendocrine tumors Block T and B cell proliferation by inhibiting the response to growth factors Unclassifiable (D) 141 142 Data not available Chemokine inhibitors…”

Section: Ustekinumab Psoriasis and Inflammatory Bowel Diseasesmentioning

confidence: 99%

Hepatitis B virus persistence and reactivation

Shi

Zheng

2020

BMJ

114

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Hepatitis B virus (HBV) infection causes chronic hepatitis and has long term complications. Individuals ever infected with HBV are at risk of viral reactivation under certain circumstances. This review summarizes studies on HBV persistence and reactivation with a focus on the definitions and mechanisms. Emphasis is placed on the interplay between HBV replication and host immunity as this interplay determines the patterns of persistence following viral acquisition. Chronic infections exhibit as overt persistence when a defective immune response fails to control the viral replication. The HBV genome persists despite an immune response in the form of covalently closed circular DNA (cccDNA) and integrated DNA, rendering an occult state of viral persistence in individuals whose infection appears to have been resolved. We have described HBV reactivation that occurs because of changes in the virus or the immune system. This review aims to raise the awareness of HBV reactivation and to understand how HBV persists, and discusses the risks of HBV reactivation in a variety of clinical settings.

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“…A total of 32 studies were identified evaluating immunosuppressing biologics and other disease-modifying antirheumatic drugs (DMARDs) for autoimmune diseases, which included rheumatoid arthritis, psoriasis, systemic lupus erythematosus, and aplastic anemia (Table 4). 67-98 TNFα inhibitors were the most common agents evaluated, and 6 studies included rituximab. Use of prophylaxis was rare.…”

Section: Resultsmentioning

confidence: 99%

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review

et al. 2018

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Risk of Hepatitis B Reactivation in Patients with Psoriasis on Ustekinumab

Abstract: The study outcomes indicate that ustekinumab could be safe for psoriasis patients since none developed persistent hepatitis or acute liver failure during therapy. However, the re-appearance of plasma HBV DNA requires appropriate monitoring of HBV viral load during ustekinumab treatment.

Cited by 51 publications

References 45 publications

Use of IL-23 Inhibitors for the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review

Use of IL-23 Inhibitors for the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review

Hepatitis B virus persistence and reactivation

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review

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