1. Long term treatment with abatacept or tocilizumab does not increase Epstein-Barr virus load in patients with rheumatoid arthritis - A three years retrospective study
- Author
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Sandrine Guis, Emmanuel Massy, Jean Roudier, Isabelle Auger, M. C. Guzian, Nathalie Balandraud, Olivier Muis-Pistor, Gaëtan Texier, Marielle Martin, Thao Pham, Arthrites autoimmunes (AA), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie [CHU Sainte Marguerite], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre d'épidémiologie et de santé publique des armées [Marseille] (CESPA), Service de Santé des Armées, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and AUGER, ISABELLE
- Subjects
Male ,Herpesvirus 4, Human ,B Cells ,[SDV]Life Sciences [q-bio] ,Arthritis ,lcsh:Medicine ,Arthritis, Rheumatoid ,Hematologic Cancers and Related Disorders ,chemistry.chemical_compound ,White Blood Cells ,0302 clinical medicine ,Animal Cells ,hemic and lymphatic diseases ,030212 general & internal medicine ,lcsh:Science ,Pathology and laboratory medicine ,Multidisciplinary ,T Cells ,Drugs ,Hematology ,Middle Aged ,Viral Load ,Medical microbiology ,Immunosuppressives ,3. Good health ,[SDV] Life Sciences [q-bio] ,Infectious Diseases ,Oncology ,Rheumatoid arthritis ,Viruses ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Drug Therapy, Combination ,Female ,Lymphomas ,Pathogens ,Cellular Types ,Viral load ,Immunosuppressive Agents ,medicine.drug ,Research Article ,Adult ,musculoskeletal diseases ,Herpesviruses ,[SDV.IMM] Life Sciences [q-bio]/Immunology ,Infectious Disease Control ,Immune Cells ,Immunology ,Lymphoproliferative disorders ,Rheumatoid Arthritis ,Antibodies, Monoclonal, Humanized ,Real-Time Polymerase Chain Reaction ,Microbiology ,Drug Administration Schedule ,Autoimmune Diseases ,Abatacept ,03 medical and health sciences ,Tocilizumab ,Rheumatology ,medicine ,Humans ,Epstein-Barr virus ,Antibody-Producing Cells ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Medicine and health sciences ,Pharmacology ,Blood Cells ,Biology and life sciences ,business.industry ,lcsh:R ,Organisms ,Viral pathogens ,Cancers and Neoplasms ,Cell Biology ,medicine.disease ,Lymphoma ,Microbial pathogens ,Methotrexate ,chemistry ,DNA, Viral ,lcsh:Q ,Clinical Immunology ,Clinical Medicine ,business ,DNA viruses - Abstract
International audience; 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.
- Published
- 2017
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