Incidência de tuberculose em pacientes com artrite reumatoide em uso de bloqueadores do TNF no Brasil: dados do Registro Brasileiro de Monitoração de Terapias Biológicas BiobadaBrasil

Yonekura, Cláudia Leiko; Oliveira, Renê Donizeti Ribeiro de; Titton, D.; Ranza, Roberto; Ranzolin, Aline; Hayata, A. L. S.; Duarte, Ângela Luzia Branco Pinto; Silveira, Inês Guimarães da; Carvalho, H.; Moraes, Júlio César Bertacini de; Abreu, Mirhelen Mendes de; Valim, Valéria; Bianchi, W.; Brenol, Claiton Viegas; Pereira, Ivânio Alves; Costa, Izaías Pereira da; Macieira, José Caetano; Miranda, José Roberto Silva; Guedes-Barbosa, Luíz Sérgio; Bértolo, Manoel Barros; Sauma, Maria de Fátima Lobato da Cunha; Silva, Marília B. G.; Freire, Marlene; Scheinberg, Morton; Toledo, Roberto Acayaba de; Oliveira, Sheila Knupp Feitosa de; Fernandes, Vander; Pinheiro, Marcelo M.; Castro, Gláucio Ricardo Werner de; Vieira, Walber Pinto; Baaklini, C.; Ruffino-Netto, Antônio; Pinheiro, Geraldo da Rocha Castelar; Laurindo, Iêda Maria Magalhães; Louzada‐Júnior, Paulo

doi:10.1016/j.rbr.2017.05.003

Cited by 28 publications

(4 citation statements)

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“…[18] Our study found a TB incidence at first anti-TNF exposure of 2.73 per 1000 patient-years exposed. This rate is similar to that found in a previous Brazilian study of RA patients (2.86 per 1000 patient-years)[31] and in studies conducted in the first years of TNF inhibitors prescribing in countries such as Italy and Canada, which reported incidence rates of 2.46 per 1000 and 2.57 per 1000 patient-years exposed, respectively. [14,34] These countries had a much lower incidence of TB in the general population than Brazil.…”

Section: Discussionsupporting

confidence: 90%

“…[44] To date, studies with BiobadaBrasil registry data have not shown any incident cases of TB in users of GOL and CZP, unlike in our cohort. [31,45]…”

Section: Discussionmentioning

confidence: 99%

“…[34,51] Extrapulmonary TB was found in 13 cases (30.2%), a rate lower than that reported in previous studies of national registry data. [31,50]…”

Section: Discussionmentioning

confidence: 99%

“…A previous study carried out in Brazil, based on records from the Brazilian Registry of Biologic Therapy Monitoring (BiobadaBrasil) maintained by the Brazilian Society of Rheumatology, found a TB incidence in RA patients with TNF inhibitors exposure of 2.8 cases per 1,000 exposed. [31] Given the higher-than-average incidence of TB in southern Brazil, it is believed that the rate of new TB cases in patients with rheumatic diseases exposed to TNF inhibitors therapy in Rio Grande do Sul may also be significantly higher than that of the general population. [18] Within this context, the primary objective of this study is to estimate the incidence of tuberculosis in patients receiving TNF inhibitors therapy for rheumatic diseases.…”

Section: Introductionmentioning

confidence: 99%

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A population-based study of tuberculosis incidence among rheumatic disease patients under anti-TNF treatment

et al. 2019

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IntroductionTuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. The advent of immunobiologic therapy with TNF inhibitors agents, has been associated with a significant increase in incident cases of tuberculosis in this population.ObjectiveTo estimate the incidence of tuberculosis in patients receiving TNF inhibitors therapy for rheumatic diseases. As secondary objectives, we sought to evaluate mortality and the clinical impact of screening for latent tuberculosis infection.MethodsThis retrospective study included patients with rheumatic diseases of Public Health System from the Brazilian state, a high TB incidence area, who received prescriptions of TNF inhibitors agents between 2006 and 2016.ResultsA total of 5853 rheumatic disease patients were included. Patients were predominantly women (68.7%) aged 49.5 (± 14.7) years old. Forty-three cases of TB were found (2.86 cases per 1000 person-years; 18 times higher than in the general population). Adalimumab and certolizumab users presented a higher risk for TB development compared to etanercept users (RR: 3.11, 95%CI 1.16–8.35; 7.47, 95%CI 1.39–40.0, respectively). In a subgroup of patients, screening for latent tuberculosis infection was performed in 86% of patients, and 30.2% had a positive tuberculin skin test. Despite latent TB treatment, TB was diagnosed in 2 out of 74 (2.7%) patients. Overall, TB diagnosis did not increase mortality.ConclusionIn this population-based study of rheumatic disease patients from a high incident area, TNF inhibitor exposure was associated with an 18-time increased TB incidence. Adalimumab and certolizumab were associated with greater and earlier TB diagnosis compared to etanercept.

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Section: Discussionsupporting

confidence: 90%

“…[44] To date, studies with BiobadaBrasil registry data have not shown any incident cases of TB in users of GOL and CZP, unlike in our cohort. [31,45]…”

Section: Discussionmentioning

confidence: 99%

“…[34,51] Extrapulmonary TB was found in 13 cases (30.2%), a rate lower than that reported in previous studies of national registry data. [31,50]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations