Biologics and risk of tuberculosis in autoimmune rheumatic diseases: A real‐world clinical experience from India

Shobha, Vineeta; Chandrashekara, S; Rao, Vijay; Desai, Anant; Jois, Ramesh; Dharmanand, BG; Kumar, Sharath; Kumar, Pradeep; Dharmapalaiah, Chethana; Mahendranath, Kurugodu M.; Prasad, Shiva; Daware, Manisha; Singh, Yogesh Preet; Karjigi, Uma; Nagaraj, Sujay; Anupama, K. R.

doi:10.1111/1756-185x.13376

Cited by 19 publications

(14 citation statements)

References 19 publications

(18 reference statements)

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“…With this strict protocol and the indicated treatment of LTBI before initiating TNF blockage therapy, eleven (5%) patients developed active TB during a median follow-up of more than 5 years. This frequency is higher than that reported in other endemic countries for rheumatic diseases ( 15 , 21 , 31 , 32 ). The most likely explanation is probably related to the long-term follow-up ( 28 ), biological class used ( 21 ), and concomitant analysis of distinct diseases in previous studies ( 15 , 31 , 32 ).…”

Section: Discussioncontrasting

confidence: 65%

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Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area

Shimabuco

Medeiros-Ribeiro²,

Miossi³

et al. 2020

Clinics

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Section: Discussioncontrasting

confidence: 65%

“…The non-homogeneous use of an LTBI screening protocol in previous studies hampers the interpretation of their findings on the relevance of each risk factor. A screening limited to a few parameters was reported by Shobha et al ( 15 ), and a low adherence to screening was also observed in the Brazilian registry ( 16 ).…”

Section: Discussionmentioning

confidence: 77%

Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area

Shimabuco

Medeiros-Ribeiro²,

Miossi³

et al. 2020

Clinics

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“…Starting with ustekinumab or anti-IL17 agents is recommended in patients with latent tuberculosis who have completed at least one month of antifungal treatment. Etanercept is the anti-TNF agent with the lowest risk of reactivation 50,51 .…”

Section: Latent Tuberculosismentioning

confidence: 99%

Expert recommendations for biological treatment in patients with psoriasis

Podoswa-Ozerkovsky¹,

Amaya-Guerra²,

Barba‐Gómez³

et al. 2023

GMM

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“…Moreover, drug-related toxicities and metabolic interactions between immunosuppressive agents and anti-TB medications may pose therapeutic challenges (14). Previous studies on TB in patients with RD focused on screening, TB incidence and clinical characteristics, compared to those of the general population (15)(16)(17)(18)(19). Little is known on TB treatment safety, adherence to standard regimen, and long-term TB outcomes in patients with RD.…”

Section: Original Articlementioning

confidence: 99%

Therapeutic issues with, and long-term outcomes of, pulmonary mycobacterial tuberculosis treatment in patients with autoimmune rheumatic diseases

et al. 2019

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Background: Real-world data on treatment safety and outcome of pulmonary tuberculosis (PTB) in patients with rheumatic diseases (RDs) are scarce. This study explored the therapeutic issues of standard first-line anti-tuberculosis (TB) medication in patients in whom PTB complicated autoimmune RDs.Methods: Observational, retrospective study was conducted in an intermediate TB burden area, South Korea. We evaluated the safety profile of, and adherence to, standard first-line anti-TB medication in PTB patients with systemic RD and assessed the long-term treatment outcomes, up to 84 months after treatment completion. Results: We included 37 patients suffering from PTB with RD (case group) and 191 without RD (control group). Rheumatoid arthritis (RA) was the most common RD (24 PTB patients, 64.9%). The frequency of severe adverse drug reactions (ADRs) was significantly higher in the case group than in the control group (36.1% vs. 12.5%, P=0.003). Severe gastrointestinal problems were the most commonly observed ADRs, with a high frequency consistently noted in both groups. Changes in first-line anti-TB medication because of severe ADRs were significantly more frequent in the case group, compared with the control group (19.4% vs. 8.3%, P=0.046). No significant between-group difference was evident in terms of long-term unfavorable outcomes (including relapse and mortality) (5.7% cases vs. 1.2% controls, P=0.146). Conclusions: Clinicians may encounter difficulties when treating PTB in patients with RD. Despite the favorable long-term outcomes of RD patients, the outcomes of individual patients such as those with systemic lupus erythematosus (SLE) should be interpreted with caution during post-therapy follow-up.

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Biologics and risk of tuberculosis in autoimmune rheumatic diseases: A real‐world clinical experience from India

Abstract: Close monitoring of patients receiving biologics is essential for early identification of adverse events, especially in test negative patients. Prophylaxis can effectively reduce the risk of developing TB in patients positive for screening.

Cited by 19 publications

References 19 publications

Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area

Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area

Expert recommendations for biological treatment in patients with psoriasis

Therapeutic issues with, and long-term outcomes of, pulmonary mycobacterial tuberculosis treatment in patients with autoimmune rheumatic diseases

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