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AB0213 Treatment and outcomes of rheumatoid arthritis patients with hepatitis b
  1. C.-B. Choi1,2,
  2. Y.-K. Sung1,2,
  3. S.-K. Cho1,2,
  4. D.-H. Yoo2,
  5. S.-S. Lee3,
  6. J. Lee4,
  7. J. Kim5,
  8. H.-S. Lee6,
  9. T.-H. Kim2,
  10. B. Y. Yoon7,
  11. W.-H. Yoo8,
  12. J.-Y. Choe9,
  13. S.-H. Lee10,
  14. S.-C. Shim11,
  15. W.-T. Chung12,
  16. S.-J. Hong13,
  17. C. K. Lee14,
  18. E. Koh15,
  19. J.-B. Jun2,
  20. S.-Y. Bang6,
  21. S.-K. Kim9,
  22. H.-S. Cha15,
  23. S. Won1,
  24. S.-C. Bae1
  1. 1Clinical Research Center for Rheumatoid Arthritis
  2. 2Rheumatology, Hanyang University Hospital For Rheumatic Diseases, Seoul
  3. 3Rheumatology, Chonnam National University Hospital, Gwangju
  4. 4Rheumatology, Ewha Womans University Mokdong Hospital, Seoul
  5. 5Rheumatology, Jeju National University Hospital, Jeju
  6. 6Rheumatology, Hanyang University Guri Hospital, Guri
  7. 7Rheumatology, Inje University Ilsan Paik Hospital, Goyang
  8. 8Rheumatology, Chonbuk National University Hospital, Jeonju
  9. 9Rheumatology, Catholic University of Daegu School of Medicine, Daegu
  10. 10Rheumatology, Konkuk University Medical Center, Seoul
  11. 11Rheumatology, Chungnam National University Hospital, Daejeon
  12. 12Rheumatology, Dong-A University Hospital, Busan
  13. 13Rheumatology, Kyung Hee University Hospital, Seoul
  14. 14Rheumatology, Yeungnam University Hospital, Daegu
  15. 15Rheumatology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea, Republic Of

Abstract

Background Treatment of rheumatoid arthritis (RA) patients with hepatitis B carries risk for reactivation of hepatitis B and drug-related hepatotoxicity.

Objectives We investigated the impact of treatment for RA in patients with hepatitis B.

Methods Patients enrolled in KORONA (Korean Observational Study Network for Arthritis) with 1-year follow up assessment with data on hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (HBcAb) status were included in the analysis. Patient characteristics (age, sex, disease duration, delay in diagnosis, alcohol intake), disease outcome measures (DAS28, fatigue, sleep, HAQ, EQ-5D, radiographic damage, surgery), medications, and adverse events were assessed. Multiple logistic regression was used to analyze the predicting factors for liver function abnormalities.

Results : A total of 871 patients were assessed. The number of HBsAg-positive and HBcAb-positive patients were 48 (5.5%) and 372 (42.7%), respectively. HBcAb-positive groups were significantly older (56.3 ± 10.8 vs 52.5 ± 9.0 in HBsAg-positive group and 51.3 ± 13.3 in negative group, p<0.01) and had longer disease duration (8.4 ± 7.7 vs 7.7 ± 6.0 in HBsAg-positive group and 7.8 ± 7.2 in negative-group, p=0.46). There was no significant difference in disease outcome measures between the groups, except for significantly increased radiographic damage in HBcAb group (79.6% vs 70.8% in HBsAg-positive group and 72.5% in negative group, p=0.048). Methotrexate and biologics use were significantly lower in HBsAg-positive group, while hydroxychloroquine, sulfasalazine, tacrolimus, and steroids use were significantly higher. HBsAg-positive group had significantly more adverse events (52.1%) compared to HBcAb-positive group (29.3%) and negative group (32.8%). HBsAg-positivity and HBcAb-positivity was not associated with significant increase in liver function abnormalities in the study population in multiple logistic regression analysis (OR (95%CI), 2.2 (0.7-7.4) and 0.8 (0.4-1.7), respectively).

Conclusions HBsAg-positive patients were more frequently treated with steroids and less with methotrexate, but there was no significant difference in disease outcome. HBsAg-positive patients had more adverse events, but it did not show significant association with developing liver function abnormality.

Acknowledgements This study is supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065).

Disclosure of Interest None Declared

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