We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Long term treatment with abatacept or tocilizumab does not increase Epstein-Barr virus load in patients with rheumatoid arthritis - A three years retrospective study.
- Authors
Balandraud, Nathalie; Texier, Gaetan; Massy, Emmanuel; Muis-Pistor, Olivier; Martin, Marielle; Auger, Isabelle; Guzian, Marie-Caroline; Guis, Sandrine; Pham, Thao; Roudier, Jean
- Abstract
Background: Epstein-Barr Virus (EBV) is a widely disseminated lymphotropic herpes virus implicated in benign and malignant disorders. In transplant patients, immunosuppressive drugs (cyclosporine) diminish control of EBV replication, potentially leading to lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) patients have impaired control of EBV infection and have EBV load ten times higher than controls. As post transplant patients, patients with RA have increased risk of developing lymphomas. Immunosuppressive drugs used to treat RA (conventional disease modifying drugs cDMARDs or biologics bDMARDs) could enhance the risk of developing LPD in RA patients. We have previously shown that long term treatment with Methotrexate and/or TNF alpha antagonists does not increase EBV load in RA. Our objective was to monitor the Epstein-Barr Virus load in RA patients treated with Abatacept (CTLA4 Ig), a T cell coactivation inhibitor, and Tocilizumab, an anti IL6 receptor antibody. Methods: EBV load in the peripheral blood mononuclear cells (PBMCs) of 55 patients under Abatacept (in 34% associated with Methotrexate) and 35 patients under Tocilizumab (in 37% associated with Methotrexate) was monitored for durations ranging from 6 months to 3 years by real time PCR. The influences of treatment duration and disease activity score 28 (DAS28) index on EBV load were analyzed. Results: Abatacept did not significantly modify EBV load over time. Tocilizumab significantly diminished EBV load over time. No patient (of 90) developed EBV associated lymphoma. Conclusion: Long term treatment with Abatacept or Tocilizumab does not increase EBV load in the PBMNCs of patients with RA.
- Subjects
TOCILIZUMAB; EPSTEIN-Barr virus; VIRAL load; RHEUMATOID arthritis treatment; RETROSPECTIVE studies
- Publication
PLoS ONE, 2017, Vol 12, Issue 2, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0171623