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Safety of secukinumab in the treatment of patients with axial spondyloarthritis and concurrent hepatitis B virus infection or latent tuberculosis infection

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Abstract

Objective

To evaluate the safety of secukinumab (SEC) in the treatment of patients with axial spondyloarthritis (axSpA) and concurrent hepatitis B virus (HBV) infection or latent tuberculosis infection (LTBI).

Methods

This is a retrospective cohort study. Adult axSpA patients with HBV infection or LTBI receiving SEC treatment for at least 3 months from March 2020 to July 2022 in Guangdong Provincial People’s Hospital were included. Patients were screened for HBV infection and LTBI before SEC treatment. During follow-up, reactivation of HBV infection and LTBI was monitored. Relevant data were collected and analyzed.

Results

A total of 43 axSpA patients with HBV infection or LTBI were included, of whom 37 were with HBV infection, 6 were with LTBI. Six out of thirty-seven (16.2%) patients with axSpA and concurrent HBV infection exhibited HBV reactivation after 9.0 ± 5.7 months of SEC treatment. Among them, 3 patients had chronic HBV infection and received anti-HBV prophylaxis, 2 patients had chronic HBV infection but did not receive anti-HBV prophylaxis, and 1 patient had occult HBV infection and did not receive antiviral prophylaxis. None of the 6 axSpA patients with LTBI developed reactivation of LTBI, whether received anti-TB prophylaxis or not.

Conclusions

HBV reactivation can occur in axSpA patients with different types of HBV infection undergoing SEC treatment, whether receive antiviral prophylaxis or not. Close monitoring of HBV reactivation in axSpA patients with HBV infection undergoing SEC treatment is mandatory. Anti-HBV prophylaxis may be beneficial. In contrast, SEC may be safe in axSpA patients with LTBI, even in patients not receiving anti-TB prophylaxis.

Key Points

•Currently, most evidence about the safety of SEC in patients with HBV infection and LTBI were from patients with psoriasis. Our study adds data about the safety of SEC in Chinese axSpA patients with concurrent HBV infection or LTBI in real-world clinical setting.

•Our study showed that HBV reactivation can occur in axSpA patients with different types of HBV infection undergoing SEC treatment, whether receive antiviral prophylaxis or not.

•Close monitoring of serum HBV markers, HBV DNA load, and liver function is mandatory in axSpA patients with chronic, occult, and resolved HBV infection undergoing SEC treatment. Anti-HBV prophylaxis may be beneficial in all HBsAg-positive patients and HBsAg-negative, HBcAb-positive patients at high risk of HBV reactivation who are receiving SEC therapy.

•None of the axSpA patients with LTBI, whether received anti-TB prophylaxis or not, developed reactivation of LTBI in our study. SEC may be safe in axSpA patients with LTBI, even in patients not receiving anti-TB prophylaxis.

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Data availability

The datasets generated and analyzed in our study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Shantou University Medical College, Shantou, China

    Suling Liu, Ziye He & Yang Cui

  2. Department of Rheumatology and Immunology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

    Suling Liu, Ziye He, Wenjing Wu, Hua Jin & Yang Cui

  3. Southern Medical University, Guangzhou, China

    Wenjing Wu

Authors
  1. Suling Liu
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  2. Ziye He
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  4. Hua Jin
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  5. Yang Cui
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Contributions

Yang Cui had the original idea of the study. All authors contributed to the study design. Suling Liu, Ziye He, Wenjing Wu, and Hua Jin collected the data. Suling Liu analyzed and interpreted the data, searched the literature, and drafted the manuscript. All authors revised the manuscript, gave the final approval of the submitted version of the manuscript, and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Yang Cui.

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Ethics approval

This study received approval from the institutional review board of Guangdong Provincial People’s Hospital with the ethics number of KY-Q-2021–164 and was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was waived because the data were collected retrospectively and only anonymized data were used in the analysis.

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Liu, S., He, Z., Wu, W. et al. Safety of secukinumab in the treatment of patients with axial spondyloarthritis and concurrent hepatitis B virus infection or latent tuberculosis infection. Clin Rheumatol 42, 2369–2376 (2023). https://doi.org/10.1007/s10067-023-06630-8

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  • DOI: https://doi.org/10.1007/s10067-023-06630-8

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