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Prevalence and management of chronic hepatitis B in pemphigus and pemphigoid patients: New evidence for the safety of rituximab.
- Source :
-
Dermatologic therapy [Dermatol Ther] 2022 Nov; Vol. 35 (11), pp. e15783. Date of Electronic Publication: 2022 Sep 04. - Publication Year :
- 2022
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Abstract
- Although the treatments of pemphigus and pemphigoid patients have tended toward safer options, patients with chronic infections seem to be still at the risk of infection reactivation when they are exposed to any of immunosuppressive treatments. A retrospective study on 1646 registered pemphigus and pemphigoid patients was conducted between January 2017 and February 2019 and the prevalence of HBV, the association between the treatments, mainly prednisolone and rituximab with HBV reactivation as well as outcomes of patients after management with antiviral therapies were evaluated. From 1646 reviewed patients, 10 (0.60%) patients with chronic HBV were identified. We found a negative correlation between the ALT (p-value<0.001), AST (p-value = 0.090), and Pemphigus Disease Area Index (PDAI) (p-value = 0.034) and age of patients. At the time points that prednisolone dosage was higher, higher levels of ALT, but no difference in AST levels was noted. The portion of patients with normal ALT was significantly higher (p-value = 0.036; OR = 2.22) in those who had received rituximab within the previous 6 months (38 of 49; 77.6%) as compared to those who did not (81 of 133; 60.9%). We concluded that avoidance (high dose) systemic corticosteroids in patients with chronic HBV, and using rituximab instead in severe cases benefit this group of patients.<br /> (© 2022 Wiley Periodicals LLC.)
- Subjects :
- Humans
Rituximab adverse effects
Hepatitis B Surface Antigens therapeutic use
Prevalence
Retrospective Studies
Virus Activation
Prednisolone therapeutic use
Hepatitis B, Chronic diagnosis
Hepatitis B, Chronic drug therapy
Hepatitis B, Chronic epidemiology
Pemphigus diagnosis
Pemphigus drug therapy
Pemphigus epidemiology
Pemphigoid, Bullous diagnosis
Pemphigoid, Bullous drug therapy
Pemphigoid, Bullous epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1529-8019
- Volume :
- 35
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Dermatologic therapy
- Publication Type :
- Academic Journal
- Accession number :
- 36001617
- Full Text :
- https://doi.org/10.1111/dth.15783