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A recent study reported long-term safety outcomes of tofacitinib for rheumatoid arthritis (RA) in global clinical trials1; the safety profile of tofacitinib exposure through 8.5 years appeared stable over time, with no new detectable safety signals. However, since most tofacitinib studies excluded patients with chronic hepatitis B (HBV) infection,1 2 the risk of HBV reactivation among tofacitinib-treated patients remains unknown.
More than two billion people globally have been infected by HBV,3 and a substantial number of patients with RA outside North America and Western Europe have coexisting HBV infection.4 HBV reactivation is a critical challenge in patients with RA receiving biological therapy5; consequently, HBV screening is recommended before initiating biologics.3 Janus kinase inhibition may counteract the suppressive effects of interferon α on viral replication6; therefore, we assessed the risk of HBV reactivation in patients receiving tofacitinib.
We established a retrospective cohort of 116 Taiwanese patients with RA who received tofacitinib at a single medical centre between April 2015 …
Contributors All authors made substantial intellectual contributions to conception of the work, the interpretation of data and approval of the final manuscript. T-YH and Y-MC conceived of the study, generated the original hypothesis, designed the study, and drafted and revised the manuscript. W-NH, Y-DW, C-TL and Y-HC acquired clinical data and analysed data. D-YC conceived of the study, analysed data and revised the manuscript.
Funding This study was supported by a grant from Taichung Veterans General Hospital, Taiwan (TCVGH-1057309C).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institution Review Board of Taichung Veterans General Hospital.
Provenance and peer review Not commissioned; externally peer reviewed.