Long-term safety of anti-TNF-α in PsA patients with concomitant HCV infection: a retrospective observational multicenter study on 15 patients

Clin Rheumatol. 2014 Feb;33(2):273-6. doi: 10.1007/s10067-013-2378-0. Epub 2013 Aug 24.


Psoriatic arthritis (PsA) is an inflammatory arthropathy associated with skin and/or nail psoriasis. TNF-α, in addition to its pro-inflammatory role, is an essential cytokine for the host's defense, and its depletion by treatment may facilitate the risk of viral infections or their reactivation. The aim of this study was to evaluate the efficacy and safety of TNF-α blockers in PsA patients with concurrent hepatitis C virus (HCV) infection. This is a multicenter study carried out in four Italian centers specialized in the diagnosis and treatment of PsA. At baseline and after 6 (T6) and 12 months (T12) of therapy, data concerning PsA activity and liver tests were registered. A total of 15 PsA patients with concomitant HCV infection were included in the study. At baseline, 13 patients had low viral load, and liver enzyme tests were within the normal range. During the observation period, these values remained stable. On the other hand, at baseline, a high viral load with slightly increased values of AST and ALT was detected in one patient. At T6 and T12, these values decreased. The remaining patient, at baseline, had low viral load, but with slightly increased AST and ALT values that normalized during the observation period. This is the greatest sample size available in the literature on this topic. The data suggests that anti-TNF-α agents are effective and safe in PsA patients with concomitant HCV. We suggest that the use of anti-TNF-α agents, accompanied by close monitoring, could be a therapeutic option.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adalimumab
  • Aged
  • Alanine Transaminase / blood
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Psoriatic / complications*
  • Arthritis, Psoriatic / drug therapy*
  • Aspartate Aminotransferases / blood
  • Biological Products / therapeutic use
  • Etanercept
  • Female
  • Hepatitis C / complications*
  • Hepatitis C / drug therapy*
  • Humans
  • Immunoglobulin G / therapeutic use
  • Inflammation
  • Male
  • Middle Aged
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Retrospective Studies
  • Time Factors
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Viral Load


  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Biological Products
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Adalimumab
  • Etanercept