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- Title
Intermediate to long-term follow-up results of INH chemoprophylaxis prior to anti-TNF-alpha therapy in a high-risk area for tuberculosis.
- Authors
Kurt, Ozlem Kar; Kurt, Bahar; Talay, Fahrettin; Tug, Tuncer; Soy, Mehmet; Bes, Cemal; Hayran, Mutlu
- Abstract
Background: The use of anti-TNF drugs for rheumatic diseases has increased in recent years. Several studies have reported an increased risk of reactivation of tuberculosis (TB) with anti-TNF agents. Objectives: The aim of this study was to present the follow-up results of a single center from Turkey, a country with a high rate of active and latent tuberculosis infection (LTBI), for INH chemoprophylaxis in patients receiving anti-TNF-α therapy for rheumatic diseases infection. Methods: In this prospective observational study, consenting patients who were to be administered an anti-TNF agent for a rheumatic disease were evaluated for the presence of active infection or LTBI by a chest X-ray and a tuberculin skin test. Patients with LTBI were given chemoprophylaxis 1 month prior to commencement of anti-TNF treatment. All patients were followed-up bimonthly for any signs of pulmonary or extrapulmonary TB. Results: A total of 73 patients, 23 female (31.5 %) and 50 male (68.5 %), with a mean age of 41.0 ± 13.1 years (18-78) were enrolled in the study. Overall, 44 patients (60.3 %) had ankylosing spondylitis, 18 (24.7 %) had rheumatoid arthritis, 7 (9.6 %) had juvenile rheumatoid arthritis, and 3 (4.1 %) had psoriatic arthritis. LTBI was identified in 58 patients all of whom received chemoprophylaxis for 9 months. None of the patients in the study developed any signs of tuberculosis reactivation during follow-up. Conclusions: TST is a reliable and cost-effective method for the diagnosis of LTBI in patients prior to anti-TNF therapy. Moreover, chemoprophylaxis with INH seems to be effective for the prevention of TB reactivation in individuals with LTBI.
- Subjects
TUBERCULOSIS treatment; TUBERCULOSIS risk factors; CHEMOPREVENTION; TUMOR necrosis factors; ANTITUBERCULAR agents; FOLLOW-up studies (Medicine)
- Publication
Wiener Klinische Wochenschrift, 2013, Vol 125, Issue 19/20, p616
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-013-0417-0