Tuberculosis, hepatitis B and herpes zoster in tofacitinib-treated patients with rheumatoid arthritis

Immunotherapy. 2019 Mar;11(4):321-333. doi: 10.2217/imt-2018-0113. Epub 2019 Jan 11.

Abstract

There is currently interest in the risk of infections during treatment with new targeted synthetic disease-modifying antirheumatic drugs (DMARDs), specifically the Janus kinase inhibitor tofacitinib. Tofacitinib has been studied extensively in patients with rheumatoid arthritis and has been shown to be effective and generally safe. East Asian countries have a high background rate of tuberculosis (TB) and hepatitis B virus (HBV) infection and the risk of recurrence or reactivation of infections such as TB, HBV and herpes zoster during DMARD therapy is of particular interest in the region. This paper reviews available data on the risk of TB, HBV and herpes zoster infections, including recurrence/reactivation of infections, during treatment with tofacitinib, with a focus on east Asia.

Keywords: hepatitis B; herpes zoster; infections; reactivated infection; recurrent infections; rheumatoid arthritis; tofacitinib; tuberculosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / epidemiology
  • Asia, Eastern / epidemiology
  • Drug Therapy, Combination
  • Herpes Zoster / epidemiology*
  • Herpesvirus 3, Human / physiology*
  • Humans
  • Mycobacterium tuberculosis / physiology*
  • Piperidines / therapeutic use*
  • Prevalence
  • Pyrimidines / therapeutic use*
  • Pyrroles / therapeutic use*
  • Recurrence
  • Risk
  • Tuberculosis / epidemiology*
  • Virus Activation

Substances

  • Antirheumatic Agents
  • Piperidines
  • Pyrimidines
  • Pyrroles
  • tofacitinib