RT Journal Article
SR Electronic
T1 Characteristics Predicting Tuberculosis Risk under Tumor Necrosis Factor-α Inhibitors: Report from a Large Multicenter Cohort with High Background Prevalence
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 524
OP 529
DO 10.3899/jrheum.150177
VO 43
IS 3
A1 Bunyamin Kisacik
A1 Omer Nuri Pamuk
A1 Ahmet Mesut Onat
A1 Sait Burak Erer
A1 Gulen Hatemi
A1 Yesim Ozguler
A1 Yavuz Pehlivan
A1 Levent Kilic
A1 Ihsan Ertenli
A1 Meryem Can
A1 Haner Direskeneli
A1 Gökhan Keser
A1 Fahrettin Oksel
A1 Ediz Dalkilic
A1 Sedat Yilmaz
A1 Salih Pay
A1 Ayse Balkarli
A1 Veli Cobankara
A1 Gözde Yildirim Cetin
A1 Mehmet Sayarlioglu
A1 Ayse Cefle
A1 Ayten Yazici
A1 Ali Berkant Avci
A1 Ender Terzioglu
A1 Suleyman Ozbek
A1 Servet Akar
A1 Ahmet Gul
YR 2016
UL http://www.jrheum.org/content/43/3/524.abstract
AB Objective. Screening strategies for latent tuberculosis (TB) before starting tumor necrosis factor (TNF)-α inhibitors have decreased the prevalence of TB among patients who are treated with these agents. However, despite vigilant screening, TB continues to be an important problem, especially in parts of the world with a high background TB prevalence. The aim of this study was to determine the factors related to TB among a large multicenter cohort of patients who were treated with anti-TNF.Methods. Fifteen rheumatology centers participated in this study. Among the 10,434 patients who were treated with anti-TNF between September 2002 and September 2012, 73 (0.69%) had developed TB. We described the demographic features and disease characteristics of these 73 patients and compared them to 7695 patients who were treated with anti-TNF, did not develop TB, and had complete data available.Results. Among the 73 patients diagnosed with TB (39 men, 34 women, mean age 43.6 ± 13 yrs), the most frequent diagnoses were ankylosing spondylitis (n = 38) and rheumatoid arthritis (n = 25). More than half of the patients had extrapulmonary TB (39/73, 53%). Six patients died (8.2%). In the logistic regression model, types of anti-TNF drugs [infliximab (IFX), OR 3.4, 95% CI 1.88–6.10, p = 0.001] and insufficient and irregular isoniazid use (< 9 mos; OR 3.15, 95% CI 1.43–6.9, p = 0.004) were independent predictors of TB development.Conclusion. Our results suggest that TB is an important complication of anti-TNF therapies in Turkey. TB chemoprophylaxis less than 9 months and the use of IFX therapy were independent risk factors for TB development.