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Infliximab May Be Safe in Certain Patients With Viral Hepatitis

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Infliximab May Be Safe in Certain Patients With Viral Hepatitis

NEW YORK (Reuters Health) Feb 27 - Infliximab, an anti-TNF-alpha antibody

used for a variety of rheumatic diseases, is not recommended for patients

with overt infectious diseases. But findings from a small case study suggest

that the drug may be safe in patients with quiescent or controlled chronic

viral hepatitis.

In a report published in the Journal of Rheumatology for January, Dr. Pascal

Claudepierre and colleagues, from Hopital Henri Mondor in Creteil, France,

describe two patients with chronic viral hepatitis who were successfully

treated with infliximab.

The first case involved a 32-year-old man with chronic hepatitis B virus

(HBV) infection and severe ankylosing spondylitis that had failed to respond

several standard therapies. After achieving control of the HBV infection

with lamivudine, the patient was started on infliximab.

The second case involved a 66-year-old woman with severe rheumatoid

arthritis who was considered for infliximab therapy due to poor tolerance to

methotrexate. During evaluation, the patient was found to have chronic

hepatitis C virus (HCV) infection but without evidence of major histologic

damage or liver test abnormalities.

In both patients, infliximab therapy produced a dramatic improvement in the

joint disease. Moreover, neither patient experienced a worsening in liver

function or virologic status.

" The two cases suggest that anti-TNF-alpha therapy may be effective and safe

in some patients with severe inflammatory joint disease and chronic viral

hepatitis, " the investigators note. " Prospective studies with liver biopsies

before, during, and after treatment cessation are now needed to validate

this hypothesis. "

J Rheumatol 2004;31:107-109.

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Infliximab May Be Safe in Certain Patients With Viral Hepatitis

NEW YORK (Reuters Health) Feb 27 - Infliximab, an anti-TNF-alpha antibody

used for a variety of rheumatic diseases, is not recommended for patients

with overt infectious diseases. But findings from a small case study suggest

that the drug may be safe in patients with quiescent or controlled chronic

viral hepatitis.

In a report published in the Journal of Rheumatology for January, Dr. Pascal

Claudepierre and colleagues, from Hopital Henri Mondor in Creteil, France,

describe two patients with chronic viral hepatitis who were successfully

treated with infliximab.

The first case involved a 32-year-old man with chronic hepatitis B virus

(HBV) infection and severe ankylosing spondylitis that had failed to respond

several standard therapies. After achieving control of the HBV infection

with lamivudine, the patient was started on infliximab.

The second case involved a 66-year-old woman with severe rheumatoid

arthritis who was considered for infliximab therapy due to poor tolerance to

methotrexate. During evaluation, the patient was found to have chronic

hepatitis C virus (HCV) infection but without evidence of major histologic

damage or liver test abnormalities.

In both patients, infliximab therapy produced a dramatic improvement in the

joint disease. Moreover, neither patient experienced a worsening in liver

function or virologic status.

" The two cases suggest that anti-TNF-alpha therapy may be effective and safe

in some patients with severe inflammatory joint disease and chronic viral

hepatitis, " the investigators note. " Prospective studies with liver biopsies

before, during, and after treatment cessation are now needed to validate

this hypothesis. "

J Rheumatol 2004;31:107-109.

Link to comment
Share on other sites

Infliximab May Be Safe in Certain Patients With Viral Hepatitis

NEW YORK (Reuters Health) Feb 27 - Infliximab, an anti-TNF-alpha antibody

used for a variety of rheumatic diseases, is not recommended for patients

with overt infectious diseases. But findings from a small case study suggest

that the drug may be safe in patients with quiescent or controlled chronic

viral hepatitis.

In a report published in the Journal of Rheumatology for January, Dr. Pascal

Claudepierre and colleagues, from Hopital Henri Mondor in Creteil, France,

describe two patients with chronic viral hepatitis who were successfully

treated with infliximab.

The first case involved a 32-year-old man with chronic hepatitis B virus

(HBV) infection and severe ankylosing spondylitis that had failed to respond

several standard therapies. After achieving control of the HBV infection

with lamivudine, the patient was started on infliximab.

The second case involved a 66-year-old woman with severe rheumatoid

arthritis who was considered for infliximab therapy due to poor tolerance to

methotrexate. During evaluation, the patient was found to have chronic

hepatitis C virus (HCV) infection but without evidence of major histologic

damage or liver test abnormalities.

In both patients, infliximab therapy produced a dramatic improvement in the

joint disease. Moreover, neither patient experienced a worsening in liver

function or virologic status.

" The two cases suggest that anti-TNF-alpha therapy may be effective and safe

in some patients with severe inflammatory joint disease and chronic viral

hepatitis, " the investigators note. " Prospective studies with liver biopsies

before, during, and after treatment cessation are now needed to validate

this hypothesis. "

J Rheumatol 2004;31:107-109.

Link to comment
Share on other sites

Infliximab May Be Safe in Certain Patients With Viral Hepatitis

NEW YORK (Reuters Health) Feb 27 - Infliximab, an anti-TNF-alpha antibody

used for a variety of rheumatic diseases, is not recommended for patients

with overt infectious diseases. But findings from a small case study suggest

that the drug may be safe in patients with quiescent or controlled chronic

viral hepatitis.

In a report published in the Journal of Rheumatology for January, Dr. Pascal

Claudepierre and colleagues, from Hopital Henri Mondor in Creteil, France,

describe two patients with chronic viral hepatitis who were successfully

treated with infliximab.

The first case involved a 32-year-old man with chronic hepatitis B virus

(HBV) infection and severe ankylosing spondylitis that had failed to respond

several standard therapies. After achieving control of the HBV infection

with lamivudine, the patient was started on infliximab.

The second case involved a 66-year-old woman with severe rheumatoid

arthritis who was considered for infliximab therapy due to poor tolerance to

methotrexate. During evaluation, the patient was found to have chronic

hepatitis C virus (HCV) infection but without evidence of major histologic

damage or liver test abnormalities.

In both patients, infliximab therapy produced a dramatic improvement in the

joint disease. Moreover, neither patient experienced a worsening in liver

function or virologic status.

" The two cases suggest that anti-TNF-alpha therapy may be effective and safe

in some patients with severe inflammatory joint disease and chronic viral

hepatitis, " the investigators note. " Prospective studies with liver biopsies

before, during, and after treatment cessation are now needed to validate

this hypothesis. "

J Rheumatol 2004;31:107-109.

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