HBV Reactivation in Patients Treated with Antitumor Necrosis Factor-Alpha (TNF-α) Agents for Rheumatic and Dermatologic Conditions: A Systematic Review and Meta-Analysis

Table 1

Source	Study; design	Patients’ HBV; status	Number of; cases^@	Age, y^#	Male, %	Followup	Pathological condition	Biologic agent	Antiviral; prophylaxis, 𝑛	Other DMARDs used
Roux et al., 2006 [26]	RS	Overt infection	3	52	100%	nr	RA	ETA, INF, ADA	Lamivudine (3)	MTX (33.3%)
Zingarelli et al., 2008 [27]	PR	Overt infection Occult infection	4	63	25%	19 months§	RA	ETA, INF, ADA, RIT	Lamivudine (4)	MTX (25%); COR (25%); HCL (25%); SSZ (25%)
Charpin et al., 2009 [13]	PR	Occult infection	21	58	38%	27 months^#	RA, AS, PsA	ETA, INF, ADA	No	MTX (47.6%); COR (23.8%)
Chung et al., 2009 [28]	RS	Occult infection	8	37	63%	nr	RA, AS	ETA, INF, ADA	No	MTX (37.5%); SSZ (50%);
Caporali et al., 2010 [11]	PR	Occult infection	67	57	55%	45.5 months^#	RA, AS, PsA	ETA, INF, ADA	No	MTX (76.1%); COR (64.1%); NSAID (77.6%);
Fotiadou et al., 2011 [29]	RS	Overt infection	7	51	43%	6–24 months	Ps	ETA, INF, ADA	Lamivudine (7)	nr
Kim et al., 2010 [14]	RS	Occult infection	88	51	51%	nr	RA, AS, PsA	ETA, INF, ADA	no	nr
Prignano et al., 2011 [30]	RS	Occult infection	12	62	75%	6 months^#	Ps	ETA, ADA	no	nr
Cassano et al., 2011 [12]	RS	Occult infection	62	54	68%	nr	Ps	ETA, INF, ADA	no	nr
Kato et al., 2011 [31]	PR	Occult infection	6	62*	23%*	8–124 weeks*	RA	ETA, INF, RIT	no	MTX (2.9%); COR (60%); CYC (42.9%); TAC (17.1%); CYA (2.9%)*
Lan et al., 2011 [15]	RS	Overt infection Occult infection	88	50.1	13%	nr	RA	ETA, ADA	Lamivudine (10)	MTX (90.9%)
Mori, 2011 [16]	PR	Overt infection Occult infection	32	73^§∗	37%*	nr	RA	ETA, INF, ADA	Entecavir (1)	MTX (90%); COR (63.3%); TAC (50%); TOC (8.3%)*
Tamori et al., 2011 [18]	PR	Overt infection Occult infection	44	59*	18%*	24 months	RA	ETA, INF, ADA	Entecavir (2)	MTX (63.3%)*
Urata et al., 2011 [19]	PR	Occult infection	52	nr	nr	12 months	RA	ETA, INF, ADA, RIT	No	MTX (48.2%); COR (38.5%); SSZ (20.7%); CYC (0.7%); TAC (6.7%); CYA (0.7%); TOC (3.0%); LEF (2.2%); BUC (20%)*
Cho et al., 2012 [32]	RS	Overt infection	7	43	86%	29 months	Ps	ETA, ADA	Lamivudine (1)	nr
Ryu et al., 2012 [17]	RS	Overt infection	49	43	61%	nr	RA, AS	ETA, INF, ADA	Lamivudine (15); Entecavir (5)	MTX (32.7%); COR (61.2%); HCL (14.3%); LEF (12.2%)
Giardina et al., 2013 [33]	PR	Overt infection Occult infection	11	57^∧	60%^∧	24 months#∧	RA, AS, PsA	ETA, IFX	Lamivudine (4)	MTX (42.1%)^∧; COR (59.6%)^∧
Laurenti et al., 2013 [34]	RS	Overt infection; Occult infection	8	54	50%	nr	PsA	ADA	Lamivudine (1)	nr
Navarro et al., 2013 [35]	RS	Overt infection	4	42	50%	25 months^#*	Ps	ETA, INF	Lamivudine (3),; Entecavir (1),; Adefovir (1)	nr
Nishida et al., 2013 [36]	RS	Overt infection	1	60	100%	47	RA	INF	No	nr
Vassilopoulos et al., 2010 [20]	PR	Overt infection Occult infection	33	52^∧	38%^∧	24 months∧	RA, AS, PsA	ETA, INF, ADA	Lamivudine (11),; Entecavir (3),; Tenfovir (1),; Telbivudine (1)	nr

nr: not reported. Study design: RS: retrospective cohort; PR: prospective cohort. Pathological condition: RA: rheumatoid arthritis; AS: ankylosing spondylitis; PsA: psoriatic arthritis; Ps: psoriasis. Biologic agent: ETA: etanercept; INF: infliximab; ADA: adalimumab; RIT: rituximab. Other DMARDs: MTX: methotrexate; COR: corticosteroids; HCL: hydroxychloroquine; SSZ: sulfasalazine; NSAID: nonsteroid anti-inflammatory drug; CYC: cyclophosphamide; TAC: tacrolimus; CYA: cyclosporin A; TOC: tocilizumab; LEF: leflunomide; BUC: bucillamine.
^@Cases included in the analysis.
^#Expressed as mean.
§Expressed as median.
*Data reported for all patients included in study, not just for those treated with anti-TNF agents.
∧Data reported for all patients included in study, not just for those with occult/overt HBV infection.