Su1338: ROLE OF HEPATITIS B SURFACE ANTIBODY FOR THE RISK OF HBV REACTIVATION DURING ANTI-TNF THERAPY

Poola, Shiva; Kratzer, MaryKate; Sanaka, Sirish; Sewell, Kerry; Tillmann, Hans L.

doi:10.1016/s0016-5085(22)63530-3

Cited by 3 publications

(2 citation statements)

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“…10 HBVr associated with rh TNFR:Fc treatment is rare; and HBVr mostly occurs either when the recommended HBV testing is performed without adhering to the recommended monitoring guidelines (such as monitoring anti-hepatitis B surface antigen antibody [anti-HBs] levels or HBV DNA) or when no testing is performed at all. 11,12 Herein, this current report describes a case of acute-on-chronic liver failure induced by rh TNFR:Fc therapy-induced occult HBV reactivation and provides a medical reference for subsequent use of drugs in patients with similar diseases.…”

Section: Introductionmentioning

confidence: 99%

Case report: Recombinant human type II tumour necrosis factor receptor-antibody fusion protein induced occult hepatitis B virus reactivation leading to liver failure

Qin,

Zhou,

Zhou

et al. 2024

J Int Med Res

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Recombinant human type II tumour necrosis factor receptor-antibody fusion protein (rh TNFR:Fc) is an immunosuppressant approved for treating rheumatoid arthritis (RA). This case report describes a case of hepatitis B reactivation in a patient with drug-induced acute-on-chronic liver failure. A 58-year-old woman with a history of RA was treated with rh TNFR:Fc; and then subsequently received 25 mg rh TNFR:Fc, twice a week, as maintenance therapy. No anti-hepatitis B virus (HBV) preventive treatment was administered. Six months later, she was hospitalized with acute jaundice. HBV reactivation was observed, leading to acute-on-chronic liver failure. After active treatment, the patient’s condition improved and she recovered well. Following careful diagnosis and treatment protocols are essential when treating RA with rh TNFR:Fc, especially in anti-hepatitis B core antigen antibody-positive patients, even when the HBV surface antigen and the HBV DNA are negative. In the case of HBV reactivation, liver function parameters, HBV surface antigen and HBV DNA should be closely monitored during treatment, and antiviral drugs should be used prophylactically when necessary, as fatal hepatitis B reactivation may occur in rare cases. A comprehensive evaluation and medication should be administered in a timely manner after evaluating the patient’s physical condition and closely monitoring the patient.

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Section: Introductionmentioning

confidence: 99%

Case report: Recombinant human type II tumour necrosis factor receptor-antibody fusion protein induced occult hepatitis B virus reactivation leading to liver failure

Qin,

Zhou,

Zhou

et al. 2024

J Int Med Res

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“…Testing for latent HBV is recommended prior to treatment with these molecules [2][3]. For high-risk patients (elderly, patients at high-risk for HBV exposure, or patients with distant history of HepB vaccination), a quantitative HepB Surface Antibody (HepB SA) test can be administered to determine immunity [4]. Among those with low HepB SA titers, it is important to ensure vaccination is current.…”

Section: Introductionmentioning

confidence: 99%

Low rates of vaccination among atopic dermatitis, alopecia areata, psoriasis, and psoriatic arthritis patients on biologics

Hren,

Khattri

2024

Arch Dermatol Res

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Biologics and Janus kinase (JAK) inhibitors are immunomodulating and immunosuppressing medications, respectively, utilized to treat atopic dermatitis (AD), psoriasis (PSO), psoriatic arthritis (PsA), and alopecia areata (AA). Special recommendations must be considered when prescribing vaccinations in this population, as the pneumococcal and herpes zoster vaccine are recommended to patients ≥ 19years-old (rather than ≥ 65-years-old and ≥ 50-years-old as in the general population, respectively), along with a yearly in uenza and up to date COVID-19 vaccination. Additionally, TNF-α and JAK-inhibitors may increase the risk of latent Hepatitis B virus (HBV) reactivation among high-risk patients. Prior to prescribing these medications, a quantitative HepB Surface Antibody (HepB SA) test is performed to determine immunity. This study utilized the SlicerDicer function on EPIC Medical Records to search for any patient ≥ 19-years-old prescribed a biologic or JAK inhibitor for AD, PSO, PsA, or AA between 10/2003-10/2023 at a large tertiary institution. Vaccination rates among patients on biologics and JAK inhibitors were low, with rates being signi cantly lower in patients 19-64 years-old, compared to those ≥ 65 years-old for most disease states (p < 0.01). Among AD, PSO/PsA, and AA patients, on average, 9.39% were vaccinated for in uenza, 6.76% for herpes zoster, 16.56% for pneumococcal pneumonia, and 63.98% for COVID-19. Only 3.16% of patients were adequately vaccinated for HepB after an abnormal HepB SA test. Here, extremely low rates of vaccination among patients on biologics and JAK inhibitors at our institution were highlighted, emphasizing the imperative need for ensuring vaccination in this patient group.

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Low Rates of Vaccination Among Atopic Dermatitis, Alopecia Areata, Psoriasis, and Psoriatic Arthritis Patients on Biologics

Hren,

Khattri

2024

Preprint

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Biologics and Janus kinase (JAK) inhibitors are immunomodulating and immunosuppressing medications, respectively, utilized to treat atopic dermatitis (AD), psoriasis (PSO), psoriatic arthritis (PsA), and alopecia areata (AA). Special recommendations must be considered when prescribing vaccinations in this population, as the pneumococcal and herpes zoster vaccine are recommended to patients ≥ 19-years-old (rather than ≥ 65-years-old and ≥ 50-years-old as in the general population, respectively), along with a yearly influenza and up to date COVID-19 vaccination. Additionally, TNF-α and JAK-inhibitors may increase the risk of latent Hepatitis B virus (HBV) reactivation among high-risk patients. Prior to prescribing these medications, a quantitative HepB Surface Antibody (HepB SA) test is performed to determine immunity. This study utilized the SlicerDicer function on EPIC Medical Records to search for any patient ≥ 19-years-old prescribed a biologic or JAK inhibitor for AD, PSO, PsA, or AA between 10/2003–10/2023 at a large tertiary institution. Vaccination rates among patients on biologics and JAK inhibitors were low, with rates being significantly lower in patients 19–64 years-old, compared to those ≥ 65 years-old for most disease states (p < 0.01). Among AD, PSO/PsA, and AA patients, on average, 9.39% were vaccinated for influenza, 6.76% for herpes zoster, 16.56% for pneumococcal pneumonia, and 63.98% for COVID-19. Only 3.16% of patients were adequately vaccinated for HepB after an abnormal HepB SA test. Here, extremely low rates of vaccination among patients on biologics and JAK inhibitors at our institution were highlighted, emphasizing the imperative need for ensuring vaccination in this patient group.

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Su1338: ROLE OF HEPATITIS B SURFACE ANTIBODY FOR THE RISK OF HBV REACTIVATION DURING ANTI-TNF THERAPY

Cited by 3 publications

References 0 publications

Case report: Recombinant human type II tumour necrosis factor receptor-antibody fusion protein induced occult hepatitis B virus reactivation leading to liver failure

Case report: Recombinant human type II tumour necrosis factor receptor-antibody fusion protein induced occult hepatitis B virus reactivation leading to liver failure

Low rates of vaccination among atopic dermatitis, alopecia areata, psoriasis, and psoriatic arthritis patients on biologics

Low Rates of Vaccination Among Atopic Dermatitis, Alopecia Areata, Psoriasis, and Psoriatic Arthritis Patients on Biologics

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