Risk of HBV reactivation in psoriasis vulgaris patients receiving biological agent therapy

ObjectiveRecently, adalimumab has become an important drug frequently used by dermatologists in the treatment of Hidradenitis suppurativa. While there are many publications by rheumatologists about the risk of hepatitis B and tuberculosis reactivation, the literature on reactivation in the treatment of hidradenitis is not extensive. With this study, we wanted to emphasize that adalimumab is a safe drug despite the risk of hepatitis B and tuberculosis reactivation and the importance of porphylaxis during the treatment of hidradenitis suppurativa.MethodsIn this study, data from 462 HS patients followed up at the Dicle University Dermatology Clinic between 1 January 2017 and 30 June 2024 were retrospectively analyzed. Adalimumab use was detected in 56 of the 462 patients. Patients over 18 years of age and used adalimumab for at least 6 months were selected for this study. Two of these patients were not included in the study because they did not meet the criteria for age and duration of adalimumab use.ResultsOf the 12 patients at risk of hepatitis B reactivation during adalimumab treatment, 8 received entecavir, and 4 received tenofovir prophylaxis. No hepatitis B reactivation was observed in any of the 12 patients during adalimumab treatment. Among the 54 patients, 4 were at risk of TB reactivation, and 4 received isoniazid as preophylactic treatment. None of the 4 patients were observed to have TB reactivation.ConclusionAdalimumab has become a frequently preferred drug in the treatment of hidradenitis, and it is known that there is a risk of hepatitis b and TBc reactivation, which should be prevented. Despite these risks, we found that adalimumab can be safely used to treat hidradenitis suppurativa, especially with the use of prophylaxis.