From the Medical Board of the National Psoriasis Foundation: Recommendations for screening for hepatitis B infection prior to initiating anti–tumor necrosis factor-alfa inhibitors or other immunosuppressive agents in patients with psoriasis - 18/12/13
Abstract |
Background |
No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents.
Objective |
We sought to give guidelines on which tests to order for hepatitis B screening.
Methods |
We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti–tumor necrosis factor-alfa therapy or other immunosuppressive agents.
Results |
We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening.
Limitations |
Conclusions based on review of available literature is a limitation.
Conclusions |
All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.
Le texte complet de cet article est disponible en PDF.Key words : anti–tumor necrosis factor-alfa, biologic therapy, cyclosporine, hepatitis B, methotrexate, psoriasis, ustekinumab
Abbreviations used : AAD, ALT, CDC, CsA, HBcAb, HBcIgM, HBeAb, HBeAg, HBsAb, HBsAg, HBV, HCC, LFT, MTX, TNF, TNFI
Plan
Funding sources: None. |
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Disclosure: Dr Van Voorhees has served as a consultant/speaker/advisor for Amgen, Abbott, Genentech, Janssen Biotech, Inc, Leo, Novartis, and Warner Chilcott. She has been an investigator for Amgen and Abbott. She also previously was a stockholder and owned stock options in Merck. Dr Lebwohl has been a consultant and investigator for Abbott, Abgenomics, Actelion, Almirall, Amgen, Anacor, Bioline Rx, Celgene, Coronado Biosciences, Covagen, Dermipsor, EliLilly, GSK-Stiefel, Janssen Biotech, Inc, Leo, Maruho, Novartis, Onset, Pfizer, Ranbaxy, Taro, and Valeant. Dr Hsu has been a consultant for Abbott, Amgen, Biogen Idec, Centocor, and Genentech. She has been a clinical investigator for Centocor. Drs Stanisic and Motaparthi have no conflicts of interest to declare. |
Vol 70 - N° 1
P. 178-186 - janvier 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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