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 language | English |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Modern Rheumatology |
| DOIs | |
| Publication status | E-pub ahead of print - Dec 22 2018 |
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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 journal › Article
}
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 -