Consider screening patients with RA for HBV exposure/infection as a part of the pretreatment assessment.
Reference1. Chen YL, Lin JZ, Mo YQ, et al. Deleterious role of hepatitis B virus infection in therapeutic response among patients with rheumatoid arthritis in a clinical practice setting: a case-control study. Arthritis Res Ther. 2018;20:81. doi: 10.1186/s13075-018-1548-5.
Chen and fellow researchers in China found that chronic hepatitis B virus (HBV) infection may lead to more rapid radiographic progression and poorer clinical responsiveness in patients with rheumatoid arthritis (RA).1
Scroll through the slides for the details of their study and the take-home messages for clinicians.
Hepatitis B virus (HBV) infection affects more than 3% of the world’s population.
HBsAg, hepatitis B surface antigen.
The study had a total of 128 matched control subjects.
EULAR, European League Against Rheumatism.
Significantly higher percentages of patients in the chronic hepatitis B group took sulfasalazine (SSZ) and hydroxychloroquine (HCQ), compared with the control group (44% vs 2% and 75% vs 11%, respectively; both P < .001). A significantly smaller proportion of patients with chronic hepatitis B took leflunomide (LEF) (16% vs 84%; P < .001).
A greater proportion of patients with chronic hepatitis B used the regimen of methotrexate (MTX) combined with SSZ and HCQ, compared with control subjects (34% vs 1%; P < .001), while a smaller percentage of patients with chronic hepatitis B used the regimen of MTX combined with LEF (9% vs 72%; P < .001).