Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis

Marco Sebastiani, Fabiola Atzeni, Laura Milazzo, Luca Quartuccio, Carlo Scirè, Giovanni Battista Gaeta, Giovanni Lapadula, Orlando Armignacco, Marcello Tavio, Ignazio Olivieri, Pierluigi Meroni, Laura Bazzichi, Walter Grassi, Alessandro Mathieu, Claudio Mastroianni, Evangelista Sagnelli, Teresa Santantonio, Caterina Uberti Foppa, Massimo Puoti, Loredana SarmatiPaolo Airò, Oscar Massimiliano Epis, Rossana Scrivo, Miriam Gargiulo, Agostino Riva, Andreina Manfredi, Giovanni Ciancio, Gianguglielmo Zehender, Gloria Taliani, Luca Meroni, Salvatore Sollima, Piercarlo Sarzi-Puttini, Massimo Galli

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The recent introduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revolutionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown.

METHODS: Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidence and produce practical, hospital-wide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations.

RESULTS: A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice.

CONCLUSIONS: A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunosuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients. Significance and Innovations HCV antibodies should be investigated at the time of diagnosis of RA and, in any case, before starting immunosuppressive therapy with disease-modifying antirheumatic drugs (DMARDs). HCV eradication with DAA should be attempted as soon as possible, depending on patient conditions allowing a continuous oral treatment lasting 8-12 weeks Conventional and biological DMARDs are allowed in patients with HCV infection, but they should be used cautiously in presence of advanced liver disease.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalModern Rheumatology
DOIs
Publication statusE-pub ahead of print - Dec 22 2018

Fingerprint

Hepatitis C
Hepacivirus
Rheumatoid Arthritis
Infection
Virus Diseases
Immunosuppressive Agents
Antiviral Agents
Antirheumatic Agents
Communicable Diseases
Therapeutics
Hepatitis C Antibodies
Evidence-Based Medicine
Rheumatology
Consultants
Liver Diseases
Pharmaceutical Preparations

Cite this

Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis. / Sebastiani, Marco; Atzeni, Fabiola; Milazzo, Laura; Quartuccio, Luca; Scirè, Carlo; Gaeta, Giovanni Battista; Lapadula, Giovanni; Armignacco, Orlando; Tavio, Marcello; Olivieri, Ignazio; Meroni, Pierluigi; Bazzichi, Laura; Grassi, Walter; Mathieu, Alessandro; Mastroianni, Claudio; Sagnelli, Evangelista; Santantonio, Teresa; Foppa, Caterina Uberti; Puoti, Massimo; Sarmati, Loredana; Airò, Paolo; Epis, Oscar Massimiliano; Scrivo, Rossana; Gargiulo, Miriam; Riva, Agostino; Manfredi, Andreina; Ciancio, Giovanni; Zehender, Gianguglielmo; Taliani, Gloria; Meroni, Luca; Sollima, Salvatore; Sarzi-Puttini, Piercarlo; Galli, Massimo.

In: Modern Rheumatology, 22.12.2018, p. 1-8.

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, Foppa, CU, 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 2018, 'Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis', Modern Rheumatology, pp. 1-8. https://doi.org/10.1080/14397595.2018.1558918
Sebastiani, Marco ; Atzeni, Fabiola ; Milazzo, Laura ; Quartuccio, Luca ; Scirè, Carlo ; Gaeta, Giovanni Battista ; Lapadula, Giovanni ; Armignacco, Orlando ; Tavio, Marcello ; Olivieri, Ignazio ; Meroni, Pierluigi ; Bazzichi, Laura ; Grassi, Walter ; Mathieu, Alessandro ; Mastroianni, Claudio ; Sagnelli, Evangelista ; Santantonio, Teresa ; Foppa, Caterina Uberti ; Puoti, Massimo ; Sarmati, Loredana ; Airò, Paolo ; Epis, Oscar Massimiliano ; Scrivo, Rossana ; Gargiulo, Miriam ; Riva, Agostino ; Manfredi, Andreina ; Ciancio, Giovanni ; Zehender, Gianguglielmo ; Taliani, Gloria ; Meroni, Luca ; Sollima, Salvatore ; Sarzi-Puttini, Piercarlo ; Galli, Massimo. / Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis. In: Modern Rheumatology. 2018 ; pp. 1-8.
@article{beadc1fe9795436da574b4de2682a29a,
title = "Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis",
abstract = "OBJECTIVES: The recent introduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revolutionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown.METHODS: Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidence and produce practical, hospital-wide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations.RESULTS: A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice.CONCLUSIONS: A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunosuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients. Significance and Innovations HCV antibodies should be investigated at the time of diagnosis of RA and, in any case, before starting immunosuppressive therapy with disease-modifying antirheumatic drugs (DMARDs). HCV eradication with DAA should be attempted as soon as possible, depending on patient conditions allowing a continuous oral treatment lasting 8-12 weeks Conventional and biological DMARDs are allowed in patients with HCV infection, but they should be used cautiously in presence of advanced liver disease.",
author = "Marco Sebastiani and Fabiola Atzeni and Laura Milazzo and Luca Quartuccio and Carlo Scir{\`e} and Gaeta, {Giovanni Battista} and Giovanni Lapadula and Orlando Armignacco and Marcello Tavio and Ignazio Olivieri and Pierluigi Meroni and Laura Bazzichi and Walter Grassi and Alessandro Mathieu and Claudio Mastroianni and Evangelista Sagnelli and Teresa Santantonio and Foppa, {Caterina Uberti} and Massimo Puoti and Loredana Sarmati and Paolo Air{\`o} and Epis, {Oscar Massimiliano} and Rossana Scrivo and Miriam Gargiulo and Agostino Riva and Andreina Manfredi and Giovanni Ciancio and Gianguglielmo Zehender and Gloria Taliani and Luca Meroni and Salvatore Sollima and Piercarlo Sarzi-Puttini and Massimo Galli",
year = "2018",
month = "12",
day = "22",
doi = "10.1080/14397595.2018.1558918",
language = "English",
pages = "1--8",
journal = "Modern Rheumatology",
issn = "1439-7595",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis

AU - Sebastiani, Marco

AU - Atzeni, Fabiola

AU - Milazzo, Laura

AU - Quartuccio, Luca

AU - Scirè, Carlo

AU - Gaeta, Giovanni Battista

AU - Lapadula, Giovanni

AU - Armignacco, Orlando

AU - Tavio, Marcello

AU - Olivieri, Ignazio

AU - Meroni, Pierluigi

AU - Bazzichi, Laura

AU - Grassi, Walter

AU - Mathieu, Alessandro

AU - Mastroianni, Claudio

AU - Sagnelli, Evangelista

AU - Santantonio, Teresa

AU - Foppa, Caterina Uberti

AU - Puoti, Massimo

AU - Sarmati, Loredana

AU - Airò, Paolo

AU - Epis, Oscar Massimiliano

AU - Scrivo, Rossana

AU - Gargiulo, Miriam

AU - Riva, Agostino

AU - Manfredi, Andreina

AU - Ciancio, Giovanni

AU - Zehender, Gianguglielmo

AU - Taliani, Gloria

AU - Meroni, Luca

AU - Sollima, Salvatore

AU - Sarzi-Puttini, Piercarlo

AU - Galli, Massimo

PY - 2018/12/22

Y1 - 2018/12/22

N2 - OBJECTIVES: The recent introduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revolutionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown.METHODS: Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidence and produce practical, hospital-wide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations.RESULTS: A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice.CONCLUSIONS: A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunosuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients. Significance and Innovations HCV antibodies should be investigated at the time of diagnosis of RA and, in any case, before starting immunosuppressive therapy with disease-modifying antirheumatic drugs (DMARDs). HCV eradication with DAA should be attempted as soon as possible, depending on patient conditions allowing a continuous oral treatment lasting 8-12 weeks Conventional and biological DMARDs are allowed in patients with HCV infection, but they should be used cautiously in presence of advanced liver disease.

AB - OBJECTIVES: The recent introduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revolutionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown.METHODS: Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidence and produce practical, hospital-wide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations.RESULTS: A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice.CONCLUSIONS: A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunosuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients. Significance and Innovations HCV antibodies should be investigated at the time of diagnosis of RA and, in any case, before starting immunosuppressive therapy with disease-modifying antirheumatic drugs (DMARDs). HCV eradication with DAA should be attempted as soon as possible, depending on patient conditions allowing a continuous oral treatment lasting 8-12 weeks Conventional and biological DMARDs are allowed in patients with HCV infection, but they should be used cautiously in presence of advanced liver disease.

U2 - 10.1080/14397595.2018.1558918

DO - 10.1080/14397595.2018.1558918

M3 - Article

C2 - 30582388

SP - 1

EP - 8

JO - Modern Rheumatology

JF - Modern Rheumatology

SN - 1439-7595

ER -