A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan
Abstract Background Patients with a history of hepatitis B virus (HBV) infection who are receiving immunosuppressive therapy are at risk of HBV reactivation and disease. Therefore, HBV screening is required prior to administering antirheumatic drugs with immunosuppressive effects. This study aimed t...
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| Format: | Article |
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BMC
2024-04-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
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| Online Access: | https://doi.org/10.1186/s40780-024-00339-9 |
| _version_ | 1797199261672144896 |
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| author | Yuki Yanagisawa Shungo Imai Hayato Kizaki Satoko Hori |
| author_facet | Yuki Yanagisawa Shungo Imai Hayato Kizaki Satoko Hori |
| author_sort | Yuki Yanagisawa |
| collection | DOAJ |
| description | Abstract Background Patients with a history of hepatitis B virus (HBV) infection who are receiving immunosuppressive therapy are at risk of HBV reactivation and disease. Therefore, HBV screening is required prior to administering antirheumatic drugs with immunosuppressive effects. This study aimed to determine the status of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis B surface antibody (HBsAb) screening prior to the initiation of drug therapy, including new antirheumatic drugs, in patients with rheumatoid arthritis. Methods This retrospective cross-sectional study used data from April 2014 to August 2022 from the Japanese hospital-based administrative claims database. The inclusion criteria were rheumatoid arthritis and first prescription date of antirheumatic drugs. Results A total of 82,282 patients with rheumatoid arthritis who were first prescribed antirheumatic drugs between April 2016 and August 2022 were included. Of the eligible patients, 9.7% (n=7,959) were screened for all HBV (HBsAg, HBsAb, and HbcAb) within 12 months prior to the date of initial prescription. The HBsAg test was performed in 30.0% (n=24,700), HBsAb test in 11.8% (n=9,717), and HBcAb test in 13.1% (n=10,824) of patients. The proportion of patients screened for HBV infection has been increasing since 2018; however, the proportion of patients screened for rheumatoid arthritis remains low. Conclusions Our findings suggest that HBV screening may be insufficient in patients who received antirheumatic drugs. With the increasing use of new immunosuppressive antirheumatic drugs, including biological agents, healthcare providers should understand the risk of HBV reactivation and conduct appropriate screening. |
| first_indexed | 2024-04-24T07:12:57Z |
| format | Article |
| id | doaj.art-6a72ba50c22b40aba81fc29f750c4c91 |
| institution | Directory Open Access Journal |
| issn | 2055-0294 |
| language | English |
| last_indexed | 2024-04-24T07:12:57Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj.art-6a72ba50c22b40aba81fc29f750c4c912024-04-21T11:25:23ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942024-04-011011910.1186/s40780-024-00339-9A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in JapanYuki Yanagisawa0Shungo Imai1Hayato Kizaki2Satoko Hori3Division of Drug Informatics, Keio University Faculty of PharmacyDivision of Drug Informatics, Keio University Faculty of PharmacyDivision of Drug Informatics, Keio University Faculty of PharmacyDivision of Drug Informatics, Keio University Faculty of PharmacyAbstract Background Patients with a history of hepatitis B virus (HBV) infection who are receiving immunosuppressive therapy are at risk of HBV reactivation and disease. Therefore, HBV screening is required prior to administering antirheumatic drugs with immunosuppressive effects. This study aimed to determine the status of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis B surface antibody (HBsAb) screening prior to the initiation of drug therapy, including new antirheumatic drugs, in patients with rheumatoid arthritis. Methods This retrospective cross-sectional study used data from April 2014 to August 2022 from the Japanese hospital-based administrative claims database. The inclusion criteria were rheumatoid arthritis and first prescription date of antirheumatic drugs. Results A total of 82,282 patients with rheumatoid arthritis who were first prescribed antirheumatic drugs between April 2016 and August 2022 were included. Of the eligible patients, 9.7% (n=7,959) were screened for all HBV (HBsAg, HBsAb, and HbcAb) within 12 months prior to the date of initial prescription. The HBsAg test was performed in 30.0% (n=24,700), HBsAb test in 11.8% (n=9,717), and HBcAb test in 13.1% (n=10,824) of patients. The proportion of patients screened for HBV infection has been increasing since 2018; however, the proportion of patients screened for rheumatoid arthritis remains low. Conclusions Our findings suggest that HBV screening may be insufficient in patients who received antirheumatic drugs. With the increasing use of new immunosuppressive antirheumatic drugs, including biological agents, healthcare providers should understand the risk of HBV reactivation and conduct appropriate screening.https://doi.org/10.1186/s40780-024-00339-9Hepatitis B virus screeningrheumatoid arthritisAntirheumatic drugsImmunosuppressive therapy |
| spellingShingle | Yuki Yanagisawa Shungo Imai Hayato Kizaki Satoko Hori A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan Journal of Pharmaceutical Health Care and Sciences Hepatitis B virus screening rheumatoid arthritis Antirheumatic drugs Immunosuppressive therapy |
| title | A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan |
| title_full | A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan |
| title_fullStr | A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan |
| title_full_unstemmed | A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan |
| title_short | A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan |
| title_sort | cross sectional survey of hepatitis b virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in japan |
| topic | Hepatitis B virus screening rheumatoid arthritis Antirheumatic drugs Immunosuppressive therapy |
| url | https://doi.org/10.1186/s40780-024-00339-9 |
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