Risk of rituximab-induced hepatitis B flare after antiviral discontinuation in rheumatic patients with chronic hepatitis B virus
Authors' conclusion
This study offers the direct evidence for the necessity of universal antiviral prophylaxis in rheumatic patients with chronic HBV receiving rituximab. After NA discontinuation, rituximab "retreatment" led to even higher flare rate and worse outcome.
Study context
- Population
- Hepatitis B surface antigen (HBsAg)-positive patients treated with rituximab for autoimmune diseases, single centre in Taiwan
- Participants
- 95 patients
- Exposure
- Nucleos(t)ide analogue (NA) prophylaxis vs no prophylaxis in HBsAg-positive patients on rituximab
- Outcome
- Hepatitis B virus (HBV)-related hepatitis (ALT >3 times baseline and concurrent HBV reactivation) after antiviral discontinuation
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
HBV-related hepatitis flare after antiviral discontinuation
| Group | Value | Flare incidence | Liver decompensation |
|---|---|---|---|
| No prophylaxis | 59% | 24.5 per 100 person-years | 8% |
No prophylaxis
Value59%
Flare incidence24.5 per 100 person-years
Liver decompensation8%
Observational data: associations, not effects.
Further findings
Flare and liver decompensation with rituximab retreatment after NA discontinuation
- Flares
- 75%
- Liver decompensation
- 63%
Flare after stopping NAs within 1 year post-rituximab, without further rituximab
- Flare rate
- 38%
Risk factors for flare
- Concurrent steroid use was a dose-dependent risk factor for flare
Original publication
Risk of rituximab-induced hepatitis B flare after antiviral discontinuation in rheumatic patients with chronic hepatitis B virus. Clin Exp Rheumatol. Published 9 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →