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Active tuberculosis risk with tumor necrosis factor inhibitors after treating latent tuberculosis.

 Minkyung Kwon  ;  Mindong Sung  ;  Yong-Jin Kwon  ;  Young Goo Song  ;  Sang-Won Lee  ;  Min-Chan Park  ;  Yong-Beom Park  ;  Soo-Kon Lee  ;  Jason Jungsik Song 
 Journal of Clinical Rheumatology, Vol.20(2) : 68-73, 2014 
Journal Title
 Journal of Clinical Rheumatology 
Issue Date
Adult ; Antirheumatic Agents/adverse effects* ; Antirheumatic Agents/therapeutic use* ; Antitubercular Agents/therapeutic use* ; Female ; Humans ; Incidence ; Latent Tuberculosis/drug therapy* ; Latent Tuberculosis/microbiology ; Male ; Middle Aged ; Mycobacterium tuberculosis ; Regression Analysis ; Republic of Korea ; Retrospective Studies ; Rheumatic Diseases/drug therapy* ; Risk Factors ; Treatment Outcome ; Tuberculosis/epidemiology* ; Tuberculosis/microbiology ; Tumor Necrosis Factor-alpha/antagonists & inhibitors*
BACKGROUND: Active tuberculosis (TB) risk increases during anti-tumor necrosis factor (TNF) therapy; therefore, latent TB infection (LTBI) screening is recommended in potential TNF inhibitor users. It is unclear whether anti-TNF therapy increases the risk of active TB infection even after standard LTBI treatment. OBJECTIVE: The objective of this study was to compare the risk of active TB development in LTBI-positive versus LBTI-negative TNF inhibitor users following the current national LTBI treatment guidelines for LTBI. METHODS: We retrospectively studied 949 TNF inhibitor users with immune-mediated inflammatory diseases from 2005 to 2012 at the Yonsei University Health System. We compared the incidence of active TB among LTBI-positive TNF inhibitor users treated according to national guidelines (n = 256) and LTBI-negative TNF inhibitor users (n = 521), using Poisson regression. RESULTS: The active TB incidence was 1107 per 100,000 patient-years in LTBI-positive TNF inhibitor users who received standard LTBI treatment and 490 per 100,000 patient-years in LTBI-negative TNF inhibitor users. Analysis showed that despite this numerical trend active TB risk was not statistically significantly elevated in LTBI-positive versus LTBI-negative TNF inhibitor users (incidence risk ratio, 2.15; P = 0.24; 95% confidence interval, 0.6-7.7). CONCLUSIONS: This study demonstrated no statistically significantly increased risk of active TB in LTBI-positive TNF inhibitor users who received standard LTBI treatment compared with LTBI-negative TNF inhibitor users.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Song, Jungsik Jason(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
Lee, Sang Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Lee, Soo Kon(이수곤)
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