Evidence map›Paper›PMID 29164002›Full record

ArticleEuropean journal of rheumatology2017

Biological therapy in arthritis patients with hepatitis B or C infection: a multicenter retrospective case series.

Sultana Abdulaziz, Hussein Halabi, Mohammed A Omair, Suzan Attar, Abdullah Alghamdi, Mohammed Shabrawishi, Abdulwahab Neyazi, Haneen Alnazzawi, Nuha Meraiani, Hani Almoallim

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Article in European journal of rheumatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sultana AbdulazizUnit of Rheumatology, Department of Medicine, King Fahd Hospital, Jeddah, Saudi Arabia.
Hussein HalabiDepartment of Medicine, King Faisal Specialist Hospital, Jeddah, Saudi Arabia.
Mohammed A OmairDivision of Rheumatology, Department of Medicine, King Saud University College of Medicine, Riyadh, Saudi Arabia.
Suzan AttarDepartment of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Abdullah AlghamdiUnit of Gastroenterology, Department of Medicine, King Fahd Hospital, Jeddah, Saudi Arabia.
Mohammed ShabrawishiDepartment of Medicine, King Faisal Specialist Hospital, Jeddah, Saudi Arabia.
Abdulwahab NeyaziDepartment of Medicine, Umm Alqura University School of Medicine, Makkah, Saudi Arabia.
Haneen AlnazzawiDepartment of Medicine, Umm Alqura University School of Medicine, Makkah, Saudi Arabia.
Nuha MeraianiDepartment of Medicine, King Faisal Specialist Hospital, Jeddah, Saudi Arabia.
Hani AlmoallimDepartment of Medicine, Umm Alqura University School of Medicine, Makkah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveReactivation of viral hepatitis B (HBV) and C (HCV) has been reported in various case reports of patients with arthritis on biological therapy. The objective of this study was to describe the clinical characteristics and outcomes of arthritis patients with HBV or HCV treated with biological therapy. MATERIAL AND

methodsThis is a retrospective case series including all patients above 13 years of age with arthritis patients from four centers in Saudi Arabia with concurrent chronic viral hepatitis infection (HBV or HCV) who received biological agents in the rheumatology clinics during their course of their disease from duration of the disease onset until last outpatient visit up to November 2015. Demographic information, full details about the hepatitis status of each patient, rheumatic disease diagnosis and different therapies used were reviewed.

resultsWe identified 10 cases each with HBV and HCV on biological therapy. The mean age in the HBV group was 51 (34-85) years and 80% were females. Eight patients had rheumatoid arthritis (RA), one patient had RA/systemic lupus erythematosus, and one had human immunodeficiency virus related-arthritis. Seven were chronic inactive HBsAg carriers and three had chronic active HBV. Nine HBV patients received prophylactic antiviral therapy. Two cases with chronic HBV had reactivation with no elevation of the transaminases.The mean age in the HCV group was 54 (23-79) years and all were female RA patients. Three had detectable hepatitis C virus-ribonuecleic acid (HCV-RNA) before the start of biological therapy. Nine HCV patients received antiviral treatment and seven had a sustained virologic response (SVR) before start of biological treatment. Three patients had detectable HCV-RNA during the course of biological therapy. One of the three was a non-responder and two were relapsers. One of the patients with HCV relapse was started on sofosbuvir plus ribavirin and achieved SVR on follow-up.

conclusionWe report the successful use of biological therapy in arthritis patients with hepatitis B infection with antiviral therapy with no detoriation of their viral status. Due to the lack of sufficient prospective studies demonstrating the rate of HCV flare on biological therapy, caution should be exercised and careful monitoring with liver enzymes and viral load is mandated in vulnerable HCV RNA patients. Treatment should be individualized by the rheumatologist in collaboration with the hepatologist to minimize complications.

Indexed as

Arthritisbiologicshepatitis Bhepatitis C

Identifiers

PMID29164002
PMCPMC5685275

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.