Guidance for the management of patients with latent tuberculosis infection requiring biologic therapy in rheumatology and dermatology clinical practice

Cantini, Fabrizio; Nannini, Carlotta; Niccoli, Laura; Iannone, Florenzo; Delogu, Giovanni; Garlaschi, Giacomo; Sanduzzi, Alessandro; Matucci, Andrea; Prignano, Francesca; Conversano, Michele; Goletti, Delia

doi:10.1016/j.autrev.2015.01.011

Cited by 157 publications

(145 citation statements)

References 65 publications

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“…Considering the large population of LTBI patients that have existing comorbidities (2), our data caution the potential pathological consequences of the use of anti-IL-17 blocking agents for treatment of inflammatory conditions in TB patients.…”

Section: Introductionmentioning

confidence: 78%

“…is further compounded by the increased prevalence of comorbidities, such as psoriasis and rheumatoid arthritis (2), as well as the emergence of drug-resistant Mtb, including both multidrug resistant (MDR) and extensively drug resistant (XDR) species. The hypoxic and necrotic microenvironment that develops within granulomas is thought to provide a niche for Mtb persistence and antibiotic resistance (3).…”

Section: Introductionmentioning

confidence: 99%

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Interleukin-17 limits hypoxia-inducible factor 1α and development of hypoxic granulomas during tuberculosis

Domingo-Gonzalez¹,

Das²,

Griffiths³

et al. 2017

JCI Insight

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Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Interleukin-17 limits hypoxia-inducible factor 1α and development of hypoxic granulomas during tuberculosis

Domingo-Gonzalez¹,

Das²,

Griffiths³

et al. 2017

JCI Insight

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“…Cantini et al (22) reviewed the risk of developing active TB in patients with rheumatic disorders receiving non-anti-TNF targeted biologics ANK (Anakinra), TCZ (Tocilizumab), RTX (Rituximab), ABA (Abatacept), and recently approved anti-TNF GOL (Golimumab) and CTP (Certolizumab Pegol). They found no cases of active TB in patients with RA (rheumatoid arthritis) and other rheumatic conditions treated with anti-CD20 + RTX and anti-CD28 ABA.…”

Section: Tnf-α Inhibitorsmentioning

confidence: 99%

“…With regard to the low risk of TB among those receiving ANK, RTX, and ABA, it can be proposed that pretreatment screening tests for LTBI detection are unnecessary prior to starting these drugs. Because all TB cases occurred in TB-endemic countries, where TB exposure could have occurred during treatment, no definitive conclusions can be drawn for TCZ, GOL, and CTP (22).…”

Section: Tnf-α Inhibitorsmentioning

confidence: 99%

“…Due to the discrepancies between TST and IGRA results and the recent data on the superior performance of combined TST and IGRAs in the detection of LTBI in those who are not BCG-vaccinated, the panel recommends the combined use of TST and IGRA as the initial tests in all patients before starting biologic agents (22 During a median 294-day follow-up period, active TB occurred in 1.4% (6/426) of the patients with negative TST and QFT-GIT results at baseline. Therefore, the authors concluded that either test strategy, using both TST and QFT-GIT assays, is acceptable for LTBI screening before commencing anti-TNF-α therapy (35).…”

Section: Diagnostic Tools For Latent Tbmentioning

confidence: 99%

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How Should We Manage Latent Tuberculosis Infection in Patients Receiving Anti-TNF-α Drugs: Literature Review

Naderi

Sheybani

Pajand

2016

Iran Red Crescent Med J

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Context: The introduction of new drugs that specifically antagonize tumor necrosis factor alpha (anti-TNF-α) has provided an effective treatment in a wide variety of autoimmune diseases. Nevertheless, the possibility of the reactivation of latent TB (Tuberculosis) infection (LTBI) among these patients is a considerable challenge. The aim of this paper is to evaluate LTBI diagnostic tools in patients who are candidates for anti-TNF-α therapy emphasizing how to manage these patients. Evidence Acquisition: A systematic web-based search was conducted in MEDLINE, Cochrane Library Database, and UpToDate ® resources using the key words "anti-TNF-α" and "latent tuberculosis" up to March 2015. Two reviewers extracted and summarized the data and suggested protocols for the diagnosis and management of LTBI in patients receiving TNF-α inhibitors. Results: There were somewhat different approaches proposed by various researchers regarding the subject. While no recommendation was found to be unique to include all patients in all situations, the data emphasize the importance of ruling out TB infection before deciding to start an anti-TNF-α drug.Conclusions: Special high-risk groups, including patients with LTBI, should be treated before receiving TNF-α inhibitors. The tuberculin skin test (TST) is a somewhat cost-effective test for the diagnosis of LTBI. However, its usefulness with respect to false results should be re-evaluated in this situation.

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Genetic polymorphisms of long noncoding RNA RP11‐37B2.1 associate with susceptibility of tuberculosis and adverse events of antituberculosis drugs in west China

Song

Liu

Zhao

et al. 2019

Clinical Laboratory Analysis

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BackgroundLittle knowledge about the biological functions of RP11‐37B2.1, a newly defined long noncoding RNA (lncRNA) molecule, is currently available. Previous studies have shown rs160441, located in the RP11‐37B2.1 gene, is significantly associated with tuberculosis (TB) in a Ghanaian and the Gambian populations.MethodsWe investigated the influence of single‐nucleotide polymorphisms (SNPs) within lncRNA RP11‐37B2.1 on the risk of TB and the possible correlation with adverse drug reactions (ADRs) from TB treatment in a Western Chinese population. Four SNPs within lncRNA RP11‐37B2.1 were genotyped in 554 TB cases and 561 healthy subjects using the improved multiplex ligation detection reaction method, and the patients were followed up monthly to monitor the development of ADRs.ResultsNo significant association between the SNPs of lncRNA RP11‐37B2.1 and TB susceptibility was observed (all P > 0.05). Surprisingly, significant association was observed between two SNPs (rs218916 and rs160441) and thrombocytopenia development during anti‐TB therapy under the dominant model (P = 0.003 and 0.014, respectively).ConclusionsOur findings firstly exhibit that rs218916 and rs160441 within lncRNA RP11‐37B2.1 significantly associate with the occurrence of thrombocytopenia and suggest RP11‐37B2.1 genetic variants are potential biosignatures for thrombocytopenia during anti‐TB treatment.

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Guidance for the management of patients with latent tuberculosis infection requiring biologic therapy in rheumatology and dermatology clinical practice

Cited by 157 publications

References 65 publications

Interleukin-17 limits hypoxia-inducible factor 1α and development of hypoxic granulomas during tuberculosis

Interleukin-17 limits hypoxia-inducible factor 1α and development of hypoxic granulomas during tuberculosis

How Should We Manage Latent Tuberculosis Infection in Patients Receiving Anti-TNF-α Drugs: Literature Review

Genetic polymorphisms of long noncoding RNA RP11‐37B2.1 associate with susceptibility of tuberculosis and adverse events of antituberculosis drugs in west China

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