Rheumatology: Current Research
Open Access

Abstract

Abatacept therapy for Rheumatoid Arthritis in patients with Hepatitis C Virus infection comorbidity: A Series of Four Patients

Megan Eshbaugh and Susan Zito

Patients with rheumatoid arthritis (RA) and hepatitis C present a diagnostic dilemma due to the viral induced immunogenistic response with subsequent biomarkers and an associated arthropathy that is difficult to distinguish from RA. They also present as a treatment dilemma due to restrictions in the use of disease modifying anti-rheumatic drugs that are standards of care such as methotrexate and leflunomide. Unfortunately they are often excluded from clinical trials in our newer RA therapeutics. In terms of biologics, beyond the American College of Rheumatology recommendations for tumor necrosis factor inhibitors, there are only case reports in alternate classes of biologic therapies. In this case report, four patients with hepatitis C are followed in terms of safety and efficacy while on abatacept (a soluble fusion protein that works as selective costimulation modulator inhibiting the activation of T cells) to treat their rheumatoid arthritis. Although each patient had varying benefit to the abatacept therapy, no patient had adverse reaction to infusion, or intolerance, and it did suggest the potential use of abatacept in this patient population.