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New RA Drug, Xeljanz, can reactivate HCV or HBV
Hi this is not a question as much as a warning. There is a new drug for RA, called Xeljanz (tofacitinib citrate) that I saw advertised in People magazine. One of the side effects is that it can reactivate HCV or HBV.
I was horrified to read about this and wanted to share. I know that doctors can prescribe medications without knowing the sx and I have read about many people on here having pain that could be related to RA.
I hope it is ok that I am posting this.
I am trying to help and I am wondering if this is possible? Can a drug really reactivate HCV?...HBV?
oh, I guess I did have a question.
Thank you
Dee
I was horrified to read about this and wanted to share. I know that doctors can prescribe medications without knowing the sx and I have read about many people on here having pain that could be related to RA.
I hope it is ok that I am posting this.
I am trying to help and I am wondering if this is possible? Can a drug really reactivate HCV?...HBV?
oh, I guess I did have a question.
Thank you
Dee
Thanks and this is interesting. Read a study on the net showing that once SVR is attained, there is still live virus. They used a very finite detection method and had 15 SVR candidates (5 natural SVR and 10 post treatment).. all had been SVR > 1yr. Very low level virus was found in lymph fluid with viral particles consistent with products of replication found in circulating blood. Now I'm a paramedic not a doctor, but I read that as the lymph system is doing it's immunological job in containing the HCV once SVR is achieved. That would be consistent with many viruses... and (in my view) the reason they carry an increased risk (all be usually very low) of various lymphomas after illness resolution. Beyond that, I did read a report of one HCV SVR patient who became detectible after radiation therapy adding further evidence to the above study. Some docs are unaware of this... mine was. Pooh made an interesting comparison argument- DNA vs RNA differentials and something worth looking into but I gotta say- if a med is known to reactivate ANY virus... I'm doing without!
As I recall....lol. My Dr. told me that even clearing the virus didnt free us from the virus. As i understood it we still carry the anti-bodies. So with that in mind it ....I will never be able to donate blood again.
In section 5.1 (Serious Infections) of Section 5 called Warnings & Precautions on the labeling: most of the sites that mention reactivating Hepatitis B & C are cached and not in the original product labeling. Just the part about Herpes zoster possibly being reactivated & those with HBV & HCV excluded from the trials.
I'm not on my computer and can't do more searching than this but I doubt this trail is going to lead anywhere. This alone would be enough to make me ask for a different medication since I am paranoid about really even being UND to begin with.
I'm not on my computer and can't do more searching than this but I doubt this trail is going to lead anywhere. This alone would be enough to make me ask for a different medication since I am paranoid about really even being UND to begin with.
Wow what a trip. I wonder what it means.
"XELJANZ may cause serious side effects including hepatitis B or C activation infection in people who carry the virus in their blood.
Hepatitis B or C activation infection in people who carry the virus in their
blood.If you are a carrier of the hepatitis B or C virus (viruses that affect the
liver), the virus may become active while you use XELJANZ. Your healthcare provider may do blood tests before you start treatment with XELJANZ and while you are using XELJANZ. Tell your healthcare provider if you have any of the following symptoms of a possible hepatitis B or C infection.
http://www.fda.gov/downloads/Drugs/DrugSafety/UCM330702.pdf
I need to read more to understand what it means though ..Wow
"XELJANZ may cause serious side effects including hepatitis B or C activation infection in people who carry the virus in their blood.
Hepatitis B or C activation infection in people who carry the virus in their
blood.If you are a carrier of the hepatitis B or C virus (viruses that affect the
liver), the virus may become active while you use XELJANZ. Your healthcare provider may do blood tests before you start treatment with XELJANZ and while you are using XELJANZ. Tell your healthcare provider if you have any of the following symptoms of a possible hepatitis B or C infection.
http://www.fda.gov/downloads/Drugs/DrugSafety/UCM330702.pdf
I need to read more to understand what it means though ..Wow
Their website www.xeljanz.com has a very vague warning for people that carry the hep B or C virus in their blood saying it can cause activation (not reactivation) of the virus. Not sure what that means or how it relates to SVR or cured HCV. Also, if you carry the virus in your blood it is already active. This definitely needs some clarification!
Here is another link to information about the drug:
" Viral Reactivation"
"Viral reactivation, including cases of herpes virus reactivation (e.g., herpes zoster), were observed in clinical studies with XELJANZ. The impact of XELJANZ on chronic viral hepatitis reactivation is unknown. Patients who screened positive for hepatitis B or C were excluded from clinical trials."
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=68e3d6b2-7838-4d2d-a417-09d919b43e13
" Viral Reactivation"
"Viral reactivation, including cases of herpes virus reactivation (e.g., herpes zoster), were observed in clinical studies with XELJANZ. The impact of XELJANZ on chronic viral hepatitis reactivation is unknown. Patients who screened positive for hepatitis B or C were excluded from clinical trials."
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=68e3d6b2-7838-4d2d-a417-09d919b43e13
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Herpes sores blister, then burst, scab and heal.
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1) I think it is a fine thing that you posted it since many people *may* be co-infected.
2) I'd rather be aware of the possibility even if it only existed in the realm of possibility. If we are unaware.... we are not able to make an informed decision.
3) We sometimes find we may be on the leading edge of information. We can share this possibility with others...other doctors.... pharmacists and then get their informed opinion.
4) IMHO...... this is not clear yet. It may exist as an improbable....or a theoretical, but why not side step such drugs until an answer is definitively known?
According to what has been posted they have actively tried to NOT find out the answer. I also think we should refrain from forming our own opinions based on the lack of evidence.
FWIW I believe that some low levels may continue to exist post SVR, the ramifications of this are not yet known....
SVR means sustained..... but..... when a new untried drug is introduced with no evidence.....since it appeared to activate/reactivate other viruses.... it would seem that this is NEW; one cannot rely on old facts to draw a new conclusion, not in the presence of a possibly stronger or more specific immune suppressing drug.
Finally..... do we all have the same immune response?
Do we all respond to interferon exactly the same?
Respond exactly the same way to immuno-suppressive drugs?
If the answer is no to the above questions.... would we be safe in relying even on a small batch of results with previously HCV infected SVR's?
Good post Dee, IMHO.
willy