Rituximab-associated hepatitis B virus (HBV) reactivation in lymphoproliferative diseases: Metaanalysis and examination of FDA safety reports

A. M. Evens, B. D. Jovanovic, Y. C. Su, D. W. Raisch, D. Ganger, S. M. Belknap, M. S. Dai, B. C.C. Chiu, B. Finte, Y. Cheng, S. S. Chuang, M. Y. Lee, T. Y. Chen, S. F. Lin, C. Y. Kuo

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237 引文 斯高帕斯(Scopus)

摘要

Background: Rituximab has been associated with hepatitis B virus reactivation (HBV-R). However, the characteristics and scope of this association remain largely undefined. Methods: We completed a comprehensive literature search of all published rituximab-associated HBV-R cases and from the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) MedWatch database. Literature and FDA cases were compared for completeness, and a meta-analysis was completed. Results: One hundred and eighty-three unique cases of rituximab-associated HBV-R were identified from the literature (n = 27 case reports, n = 156 case series). The time from last rituximab to reactivation was 3 months (range 0-12), although 29% occurred >6 months after last rituximab. Within FDA data (n = 118 cases), there was a strong signal for rituximabassociated HBV-R [proportional reporting ratio = 28.5, 95% confidence interval (CI) 23.9-34.1; Empiric Bayes Geometric Mean = 26.4, 95% CI 21.4-31.1]. However, the completeness of data in FDA reports was significantly inferior compared with literature cases (P < 0.0001). Among HBV core antibody (HBcAb(+)) series, the pooled effect of rituximab-based therapy showed a significantly increased risk of HBV-R compared with nonrituximab-treated patients (odds ratio 5.73, 95% CI 2.01-16.33; Z = 3.33, P = 0.0009) without heterogeneity (χ2 = 2.12, P = 0.5473). Conclusions: The FDA AERS provided strong HBV-R safety signals; however, literature-based cases provided a significantly more complete description. Furthermore, meta-analysis of HBcAb(+) series identified a more than fivefold increased rate of rituximab-associated HBV-R.

原文English
頁(從 - 到)1170-1180
頁數11
期刊Annals of Oncology
22
發行號5
DOIs
出版狀態Published - 2011 五月

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology

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