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

Area of Science:

• Rheumatology
• Infectious Diseases
• Pharmacology

Background:

• Targeted synthetic disease-modifying antirheumatic drugs (DMARDs), like tofacitinib, are increasingly used for rheumatoid arthritis.
• East Asian countries face high endemic rates of tuberculosis (TB) and hepatitis B virus (HBV) infections.
• Concerns exist regarding the risk of infections, including reactivation, with Janus kinase (JAK) inhibitors.

Purpose of the Study:

• To review available data on the risk of TB, HBV, and herpes zoster infections during tofacitinib treatment.
• To focus specifically on the risk of infection recurrence or reactivation in East Asian populations.
• To assess the safety profile of tofacitinib concerning infectious complications.

Main Methods:

• Literature review of studies on tofacitinib and infection risks.
• Analysis of data focusing on tuberculosis, hepatitis B virus, and herpes zoster.
• Emphasis on studies conducted in or relevant to East Asian populations.

Main Results:

• Tofacitinib is effective for rheumatoid arthritis but carries potential infection risks.
• Data suggests an increased risk of TB, HBV, and herpes zoster reactivation with tofacitinib use.
• These risks are of heightened concern in East Asian regions due to high background infection rates.

Conclusions:

• Healthcare providers should carefully consider the risk of TB, HBV, and herpes zoster reactivation in patients on tofacitinib, especially in East Asia.
• Monitoring and prophylactic measures may be necessary for patients initiating tofacitinib in endemic areas.
• Further research is warranted to fully elucidate and manage infection risks associated with JAK inhibitors.