Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis

M Sebastiani, F Atzeni, L Milazzo, L Quartuccio, C Scirè, GB Gaeta, G Lapadula, O Armignacco, M Tavio, I Olivieri, P Meroni, L Bazzichi, W Grassi, A Mathieu, C Mastroianni, E Sagnelli, T Santantonio, C Uberti Foppa, M Puoti, L Sarmati & 13 others P Airò, OM Epis, R Scrivo, M Gargiulo, A Riva, A Manfredi, G Ciancio, G Zehender, G Taliani, L Meroni, S Sollima, P Sarzi-Puttini, M Galli

Research output: Contribution to journalArticle

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Abstract

Objectives: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. Methods: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Center for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations. Results: A core-set of statements has been developed to help clinicians in the management of patients with RA and HBV infection. Vaccination and prophylaxis of RA patients treated with biological drugs have been also discussed. Conclusions: HBV infection is not rare in clinical practice; a screening for HBV in all patients with early arthritis is not universally accepted, while it is considered mandatory before starting any immunosuppressive or hepatotoxic treatment. In fact, a specific risk, associated with the use of biologic treatments, exists for patients with HBV infection, although longitudinal studies of viral reactivation are generally reassuring. RA patients with HBV infection should be referred to the hepatologist and correctly classified into active or inactive carriers. Patients with active hepatitis B should undergo antiviral treatment before starting immunosuppressive treatments. Occult HBV carriers should be monitored or receive prophylaxis on the basis of the risk of reactivation associated with the administered treatment. © 2017 Société française de rhumatologie.
Original languageEnglish
Pages (from-to)525-530
Number of pages6
JournalJoint Bone Spine
Volume84
Issue number5
DOIs
Publication statusPublished - 2017

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Virus Diseases
Hepatitis B virus
Rheumatoid Arthritis
Guidelines
Infection
Immunosuppressive Agents
Hepatitis B
Communicable Diseases
Therapeutics
Evidence-Based Medicine
Rheumatology
Consultants
Arthritis
Antiviral Agents
Longitudinal Studies
Vaccination
Pharmaceutical Preparations

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Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis. / Sebastiani, M; Atzeni, F; Milazzo, L; Quartuccio, L; Scirè, C; Gaeta, GB; Lapadula, G; Armignacco, O; Tavio, M; Olivieri, I; Meroni, P; Bazzichi, L; Grassi, W; Mathieu, A; Mastroianni, C; Sagnelli, E; Santantonio, T; Uberti Foppa, C; Puoti, M; Sarmati, L; Airò, P; Epis, OM; Scrivo, R; Gargiulo, M; Riva, A; Manfredi, A; Ciancio, G; Zehender, G; Taliani, G; Meroni, L; Sollima, S; Sarzi-Puttini, P; Galli, M.

In: Joint Bone Spine, Vol. 84, No. 5, 2017, p. 525-530.

Research output: Contribution to journalArticle

Sebastiani, M, Atzeni, F, Milazzo, L, Quartuccio, L, Scirè, C, Gaeta, GB, Lapadula, G, Armignacco, O, Tavio, M, Olivieri, I, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airò, P, Epis, OM, Scrivo, R, Gargiulo, M, Riva, A, Manfredi, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P & Galli, M 2017, 'Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis', Joint Bone Spine, vol. 84, no. 5, pp. 525-530. https://doi.org/10.1016/j.jbspin.2017.05.013
Sebastiani, M ; Atzeni, F ; Milazzo, L ; Quartuccio, L ; Scirè, C ; Gaeta, GB ; Lapadula, G ; Armignacco, O ; Tavio, M ; Olivieri, I ; Meroni, P ; Bazzichi, L ; Grassi, W ; Mathieu, A ; Mastroianni, C ; Sagnelli, E ; Santantonio, T ; Uberti Foppa, C ; Puoti, M ; Sarmati, L ; Airò, P ; Epis, OM ; Scrivo, R ; Gargiulo, M ; Riva, A ; Manfredi, A ; Ciancio, G ; Zehender, G ; Taliani, G ; Meroni, L ; Sollima, S ; Sarzi-Puttini, P ; Galli, M. / Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis. In: Joint Bone Spine. 2017 ; Vol. 84, No. 5. pp. 525-530.
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abstract = "Objectives: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. Methods: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Center for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations. Results: A core-set of statements has been developed to help clinicians in the management of patients with RA and HBV infection. Vaccination and prophylaxis of RA patients treated with biological drugs have been also discussed. Conclusions: HBV infection is not rare in clinical practice; a screening for HBV in all patients with early arthritis is not universally accepted, while it is considered mandatory before starting any immunosuppressive or hepatotoxic treatment. In fact, a specific risk, associated with the use of biologic treatments, exists for patients with HBV infection, although longitudinal studies of viral reactivation are generally reassuring. RA patients with HBV infection should be referred to the hepatologist and correctly classified into active or inactive carriers. Patients with active hepatitis B should undergo antiviral treatment before starting immunosuppressive treatments. Occult HBV carriers should be monitored or receive prophylaxis on the basis of the risk of reactivation associated with the administered treatment. {\circledC} 2017 Soci{\'e}t{\'e} fran{\cc}aise de rhumatologie.",
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TY - JOUR

T1 - Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis

AU - Sebastiani, M

AU - Atzeni, F

AU - Milazzo, L

AU - Quartuccio, L

AU - Scirè, C

AU - Gaeta, GB

AU - Lapadula, G

AU - Armignacco, O

AU - Tavio, M

AU - Olivieri, I

AU - Meroni, P

AU - Bazzichi, L

AU - Grassi, W

AU - Mathieu, A

AU - Mastroianni, C

AU - Sagnelli, E

AU - Santantonio, T

AU - Uberti Foppa, C

AU - Puoti, M

AU - Sarmati, L

AU - Airò, P

AU - Epis, OM

AU - Scrivo, R

AU - Gargiulo, M

AU - Riva, A

AU - Manfredi, A

AU - Ciancio, G

AU - Zehender, G

AU - Taliani, G

AU - Meroni, L

AU - Sollima, S

AU - Sarzi-Puttini, P

AU - Galli, M

PY - 2017

Y1 - 2017

N2 - Objectives: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. Methods: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Center for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations. Results: A core-set of statements has been developed to help clinicians in the management of patients with RA and HBV infection. Vaccination and prophylaxis of RA patients treated with biological drugs have been also discussed. Conclusions: HBV infection is not rare in clinical practice; a screening for HBV in all patients with early arthritis is not universally accepted, while it is considered mandatory before starting any immunosuppressive or hepatotoxic treatment. In fact, a specific risk, associated with the use of biologic treatments, exists for patients with HBV infection, although longitudinal studies of viral reactivation are generally reassuring. RA patients with HBV infection should be referred to the hepatologist and correctly classified into active or inactive carriers. Patients with active hepatitis B should undergo antiviral treatment before starting immunosuppressive treatments. Occult HBV carriers should be monitored or receive prophylaxis on the basis of the risk of reactivation associated with the administered treatment. © 2017 Société française de rhumatologie.

AB - Objectives: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. Methods: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Center for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations. Results: A core-set of statements has been developed to help clinicians in the management of patients with RA and HBV infection. Vaccination and prophylaxis of RA patients treated with biological drugs have been also discussed. Conclusions: HBV infection is not rare in clinical practice; a screening for HBV in all patients with early arthritis is not universally accepted, while it is considered mandatory before starting any immunosuppressive or hepatotoxic treatment. In fact, a specific risk, associated with the use of biologic treatments, exists for patients with HBV infection, although longitudinal studies of viral reactivation are generally reassuring. RA patients with HBV infection should be referred to the hepatologist and correctly classified into active or inactive carriers. Patients with active hepatitis B should undergo antiviral treatment before starting immunosuppressive treatments. Occult HBV carriers should be monitored or receive prophylaxis on the basis of the risk of reactivation associated with the administered treatment. © 2017 Société française de rhumatologie.

U2 - 10.1016/j.jbspin.2017.05.013

DO - 10.1016/j.jbspin.2017.05.013

M3 - Article

VL - 84

SP - 525

EP - 530

JO - Revue du Rhumatisme (English Edition)

JF - Revue du Rhumatisme (English Edition)

SN - 1169-8446

IS - 5

ER -