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Long-term safety of rituximab in patients with rheumatic diseases and chronic or resolved hepatitis B virus infection
  1. Ioannnis Mitroulis1,
  2. Chrisoula Hatzara2,
  3. Anna Kandili2,
  4. Emilia Hadziyannis2,
  5. Dimitrios Vassilopoulos2
  1. 11st Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
  2. 22nd Department of Medicine, Athens University School of Medicine, Hippokration General Hospital, Athens, Greece
  1. Correspondence to Dr Dimitrios Vassilopoulos, 2nd Department of Medicine, Hippokration General Hospital, Athens University School of Medicine, 114 Vass. Sophias Ave., Athens 115 27, Greece; dvassilop{at}med.uoa.gr

https://doi.org/10.1136/annrheumdis-2012-202088

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    Patients with rheumatic diseases and chronic, or less frequently, resolved hepatitis B virus (HBV) infection, can develop viral reactivation during antitumor necrosis factor therapy.1–3 Treatment with chemotherapeutic regimens that includes rituximab (RTX) without prophylactic antiviral therapy, has been linked to HBV reactivation in lymphoma patients with chronic (27%–80%), or resolved (3%–25%) HBV infection.1 ,4 Since there are no data available for rheumatic patients, we studied the safety of RTX in such patients with chronic or resolved HBV infection.

    Forty-one consecutive patients with various rheumatic diseases (rheumatoid arthritis/RA: n=34, other: n=7) who had received ≥1 cycle of RTX and had ≥6 months of follow-up were included in this prospective study. Patients were treated with the standard dose of RTX (1 gm intravenous at days 1 and 15, table 1). Patients were screened for HBV at baseline (HBsAg, anti-HBc, anti-HBs); those found …

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    Footnotes

    • Contributors IM: participated in data acquisition, analysis and interpretation; drafting, revision and final approval of the manuscript; CH: participated in data acquisition; drafting, revision and final approval of the manuscript; AK: participated in data acquisition; drafting, revision and final approval of the manuscript; EH participated in study conception, design and supervision; data analysis and interpretation; drafting, revision and final approval of the report; DV: participated in study conception, design and supervision; data acquisition, analysis and interpretation; and drafting, revision and final approval of the report.

    • Funding This research is funded by the Hellenic Society for Rheumatology, Special Account for Research Grants (SARG), National and Kapodistrian University of Athens, Athens, Greece.

    • Competing interests None.

    • Ethics approval Institutional Review Board.

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