PT - JOURNAL ARTICLE AU - Fabrizio Cantini AU - Francesca Prignano AU - Delia Goletti TI - Restarting Biologics and Management of Patients with Flares of Inflammatory Rheumatic Disorders or Psoriasis During Active Tuberculosis Treatment AID - 10.3899/jrheum.140106 DP - 2014 May 01 TA - The Journal of Rheumatology PG - 78--82 VI - 91 4099 - http://www.jrheum.org/content/91/78.short 4100 - http://www.jrheum.org/content/91/78.full SO - J Rheumatol2014 May 01; 91 AB - Our aim was to review the evidence concerning optimal timing for restarting biologics in patients with active tuberculosis (TB), and the management of relapsing rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and psoriasis during treatment for TB. Few or no indications are available for 2 important challenges for clinicians: the timing for restarting biologics in patients with TB reactivation and the management of the underlying disorder. In the absence of clear evidence, guidelines and experts suggest restarting anti-tumor necrosis factor-α (TNF-α) agents after completion of an active TB therapy course, but no indications are available on the appropriate management of patients with flares of underlying rheumatic disease or psoriasis. Among anti-TNF-α agents, etanercept is associated with the lowest risk of TB reactivation, and non-anti-TNF-α biologics and several nonbiologic drugs are associated with low/no risk of TB reactivation. Therefore, for patients with relapsing RA, PsA, AS, or psoriasis during TB treatment we propose a therapeutic schedule modulated by disease activity and individual single drug-related TB risk.