TY - JOUR
T1 - A drug safety evaluation of rituximab and risk of hepatitis B
AU - Riedell, Peter
AU - Carson, Kenneth R.
N1 - Funding Information:
The authors are funded by the American Cancer Society (MSRG-12-077-01-CPHPS). KR Carson has previously performed consulting service and been a member of a speakers’ bureau for Genentech, manufacturer of rituximab. P Riedell has no disclosures. They have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
PY - 2014/7
Y1 - 2014/7
N2 - Introduction: Rituximab is a widely prescribed anti-CD20 mAb for the treatment of CD20+ B-cell non-Hodgkin Lymphoma and many other immune mediated conditions. There is a well-described association between rituximab containing chemo-immunotherapy treatment and reactivation of the hepatitis B virus (HBV). This review summarizes the current literature surrounding rituximab-associated HBV reactivation.Areas covered: Herein, we review the literature detailing the risk of HBV reactivation in inactive carriers and those with resolved hepatitis. The clinical presentation and management of HBV reactivation are also discussed along with a summary of clinical trials evaluating antiviral prophylaxis. Finally, clinical recommendations are detailed. Data from clinical trials, observational studies, reviews, and meta-analyses available in the Medline database were included in this narrative review.Expert opinion: Screening should be performed in all patients prior to the administration of any type of anti-CD20 mAb therapy. Among those with positive screening serology, testing for hepatitis B e antigen or viral load by polymerase chain reaction is appropriate. In those patients with detectable HBV DNA, the decision regarding the use of antiviral prophylaxis or observation should be individualized.
AB - Introduction: Rituximab is a widely prescribed anti-CD20 mAb for the treatment of CD20+ B-cell non-Hodgkin Lymphoma and many other immune mediated conditions. There is a well-described association between rituximab containing chemo-immunotherapy treatment and reactivation of the hepatitis B virus (HBV). This review summarizes the current literature surrounding rituximab-associated HBV reactivation.Areas covered: Herein, we review the literature detailing the risk of HBV reactivation in inactive carriers and those with resolved hepatitis. The clinical presentation and management of HBV reactivation are also discussed along with a summary of clinical trials evaluating antiviral prophylaxis. Finally, clinical recommendations are detailed. Data from clinical trials, observational studies, reviews, and meta-analyses available in the Medline database were included in this narrative review.Expert opinion: Screening should be performed in all patients prior to the administration of any type of anti-CD20 mAb therapy. Among those with positive screening serology, testing for hepatitis B e antigen or viral load by polymerase chain reaction is appropriate. In those patients with detectable HBV DNA, the decision regarding the use of antiviral prophylaxis or observation should be individualized.
KW - Antiviral prophylaxis
KW - Hepatitis B
KW - Rituximab
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=84902653326&partnerID=8YFLogxK
U2 - 10.1517/14740338.2014.918948
DO - 10.1517/14740338.2014.918948
M3 - Article
C2 - 24821316
AN - SCOPUS:84902653326
SN - 1474-0338
VL - 13
SP - 977
EP - 987
JO - Expert Opinion on Drug Safety
JF - Expert Opinion on Drug Safety
IS - 7
ER -