Hep B screening urged before TNF-alpha inhibitor therapy

July 1, 2012
Hep B screening urged before TNF-alpha inhibitor therapy
All patients with psoriasis should be screened for hepatitis B surface antigen and hepatitis B core antibody prior to the initiation of tumor necrosis factor-alpha inhibitor therapy, according to research published online June 25 in the Journal of the American Academy of Dermatology.

(HealthDay) -- All patients with psoriasis should be screened for hepatitis B surface antigen and hepatitis B core antibody prior to the initiation of tumor necrosis factor-alpha inhibitor therapy, according to research published online June 25 in the Journal of the American Academy of Dermatology.

Amanda Abramson, M.D., from the Baylor University Medical Center in Dallas, and colleagues reviewed the literature for studies to provide guidance for dermatologists on the use of tumor necrosis factor-alpha inhibitory agents (etanercept, adalimumab, and infliximab) for patients with psoriasis who have hepatitis B.

The researchers found that, in patients with psoriasis who are hepatitis B surface antigen-positive, treatment with tumor necrosis factor-alpha inhibitors may result in reactivated hepatitis B. Patients with an isolated positive hepatitis B core antibody may also experience reactivation, although this occurred less frequently. Compared with the other two agents, infliximab was associated with more cases of reactivation and there were fatalities reported with this agent. Evidence suggested that early or pre-emptive antiviral therapy can greatly minimized or eliminate the risk of reactivation.

"Hepatitis B screening is essential prior to the initiation of tumor necrosis factor-alpha inhibitor therapy," the authors write. "Psoriatic patients found to be hepatitis B surface antigen or core antibody-positive should be referred to an appropriate specialist for evaluation and therapy. This would allow for the safe use of tumor necrosis factor-alpha inhibitors in psoriatic patients despite recently published guidelines to the contrary."

Several authors disclosed to the pharmaceutical industry.

Explore further: Analysis finds mortality from all causes higher among hepatitis C-infected

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

UVB preferred for treatment of moderate to severe psoriasis

February 24, 2012

(HealthDay) -- Ultraviolet B (UVB) is preferred by dermatologists for first-line treatment of moderate to severe psoriasis in both healthy male and female patients, according to a study published in the March issue of the ...

Recommended for you

Cellphone data can track infectious diseases

August 20, 2015

Tracking mobile phone data is often associated with privacy issues, but these vast datasets could be the key to understanding how infectious diseases are spread seasonally, according to a study published in the Proceedings ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.