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  • Comparisons of hepatitis C viral replication in patients with rheumatoid arthritis receiving tocilizumab, abatacept and tofacitinib therapy

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Comparisons of hepatitis C viral replication in patients with rheumatoid arthritis receiving tocilizumab, abatacept and tofacitinib therapy
  1. Yi-Ming Chen1,2,3,4,
  2. Wen-Nan Huang1,3,
  3. Tsai-Ling Liao2,4,
  4. Jun-Pen Chen2,
  5. Sheng-Shun Yang3,5,
  6. Hsin-Hua Chen1,2,3,4,
  7. Tsu-Yi Hsieh1,
  8. Wei-Ting Hung1,
  9. Yi-Hsing Chen1,3,
  10. Der-Yuan Chen6,7
  1. 1 Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
  2. 2 Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
  3. 3 Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
  4. 4 Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
  5. 5 Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan
  6. 6 Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
  7. 7 School of Medicine, China Medical University, Taichung, Taiwan
  1. Correspondence to Professor Der-Yuan Chen, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, 40447, Taiwan; dychen{at}vghtc.gov.tw; Dr Yi-Hsing Chen, Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 40705, Taiwan; ysanne{at}vghtc.gov.tw

http://dx.doi.org/10.1136/annrheumdis-2018-214400

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    Despite recent advances in direct antiviral agents for hepatitis C virus (HCV), this infectious disease remains prevalent worldwide and presents a major therapeutic challenge in patients with rheumatoid arthritis (RA).1 Our previous report demonstrated that use of antitumour necrosis factor (TNF)-α agents in patients with RA with HCV infection appears to be safe.2 However, B-cell-targeted therapy with rituximab may lead to HCV viraemia by causing a decline in exosomal microRNAs.3 Therefore, HCV viral replication may respond differently to biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) owing to the different mechanism of action in patients with RA.

    Viral loads in HCV-infected patients with RA were reported to be unaffected during short-term therapy with tocilizumab, a monoclonal antibody targeting interleukin (IL)-6 receptor.4 5 Abatacept, a fusion protein binding cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) that blocks the CD80/CD86 costimulatory pathways, has also been shown to be safe in patients with RA with HCV.6 It remains unclear whether tofacitinib, a Janus kinase (JAK) inhibitor,7 affects HCV viral activity in patients with RA. To …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors Y-MC and W-NH conceived and designed the study, conducted the data analysis, and drafted and revised the manuscript. J-PC performed the statistical analysis and revised the manuscript. T-LL, S-SY, H-HC, T-YH and W-TH acquired clinical data and revised the manuscript. D-YC and Y-HC generated the original hypothesis, conceived and designed the study, acquired clinical data, conducted the data analysis, and drafted and revised the manuscript.

    • Funding This study was supported by a grant from Taichung Veterans General Hospital, Taiwan (TCVGH-1077307C).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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