Diagnosis and treatment of latent tuberculosis infection in arthritis patients treated with tumor necrosis factor antagonists in Korea

J Korean Med Sci. 2007 Oct;22(5):779-83. doi: 10.3346/jkms.2007.22.5.779.

Abstract

Tumor necrosis factor (TNF) is essential for host defense against Mycobacterium tuberculosis, and the risk of reactivation of latent tuberculosis infection (LTBI) increases with anti-TNF therapy. This study estimated the prevalence of LTBI and evaluated the safety and completion rate of short-course therapy with isoniazid plus rifampin for 3 months to treat LTBI in a cohort of Korean arthritis patients before initiating anti-TNF therapy. We retrospectively studied the files of 112 consecutive patients to evaluate LTBI before starting anti-TNF drugs. Screening tests were performed, including a tuberculin skin test and chest radiography. LTBI treatment was indicated in 41 patients (37%). Of these, three patients refused the LTBI treatment. Of the 38 patients who underwent LTBI treatment, 36 (95%) took isoniazid plus rifampin for 3 months. Six patients (16%) showed transient elevations of liver enzymes during the LTBI treatment. Overall, 35 patients (92%) completed the LTBI treatment as planned. In conclusion, LTBI was diagnosed in one-third of Korean arthritis patients before initiating anti-TNF therapy. A high percentage of these patients completed 3 months of LTBI treatment with isoniazid plus rifampin without serious complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibiotics, Antitubercular / pharmacology
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / drug therapy*
  • Female
  • Humans
  • Korea
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rifampin / pharmacology
  • Spondylitis / metabolism
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / diagnosis
  • Spondylitis, Ankylosing / drug therapy
  • Tuberculin Test
  • Tuberculosis / complications*
  • Tuberculosis / diagnosis*
  • Tuberculosis / drug therapy*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Antibiotics, Antitubercular
  • Tumor Necrosis Factor-alpha
  • Rifampin