Spondyloarthritis & psoriatic arthritis
Hepatitis B reactivation in PsA patients: an SLR and meta-analysis for IL-17, IL-23 and JAK inhibitors
Authors' conclusion
Overall, our meta-analysis shows that patients with chronic HBV receiving anti-IL-17, anti-IL-12/23, anti-IL-23 and JAK-inhibitors have significant risk for HBVr, especially if they are not under anti-viral treatment. In contrast, resolved HBV seems to offer minor risk for HBVr even without anti-viral treatment.
Study context
- Population
- Patients with chronic or prior HBV infection treated with anti-IL17, anti-IL12/23, anti-IL23 or JAK inhibitors (PsA)
- Comparison
- HBV reactivation risk with IL-17i, anti-IL-12/23, IL-23i and JAKi in chronic vs resolved HBV
- Outcome
- HBV reactivation (HBVr) risk
Methodological detailsfixed and random effects
- Fixed and random effects
Pooled result
As reported in the abstract
HBVr rate, chronic vs resolved HBV
P < 0.01
- Low HBV reactivation (HBVr) risk in all agents
- <6%
Further pooled results
- HBVr rate without anti-viral treatment — Chronic HBV
- 28%
- HBVr rate without anti-viral treatment — HBVr rate in patients with resolved hepatitis (respective percentage)
- 4.7%
- HBVr rate by drug class: Anti-IL-17 4% (95% CI 1–9%)
- HBVr rate by drug class: Anti-IL-12/IL-23 2% (95% CI 0–5%)
- HBVr rate by drug class: JAKi 4% (95% CI 1–8%)
- HBVr rate by drug class: Anti-IL23 0%
HBVr rate by drug class
- No difference among different drugs in the HBVr rates
Original publication
Hepatitis B reactivation in PsA patients: an SLR and meta-analysis for IL-17, IL-23 and JAK inhibitors. Rheumatology (Oxford). Published 17 August 2024. doi:10.
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