Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test?

Alasan, Fatih; Balbay, Ege Güleç; Cangür, Şengül; Balbay, Öner; Aydın, Leyla Yılmaz; Annakkaya, Ali Nihat

doi:10.1080/13685538.2019.1678582

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…In another study in a population of 110 patients, 65 (59%) patients with TST ≥5 mm received INH prophylaxis. Two (1.8%) patients developed active TB despite BCG vaccination and received INH prophylaxis 29 . In another study in Turkey, the incidence of TB was 1.1% among patients with anti‐TNF treatment, nearly 23 times higher than the rate in the general population 30 .…”

Section: Discussionmentioning

confidence: 94%

Determination of tuberculin skin test for isoniazid prophylaxis in BCG vaccinated children who are using anti‐TNF agents for rheumatologic diseases

Kılınç

Önal

Öztosun

et al. 2020

Pediatric Pulmonology

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Objective The use of tumor necrosis factor inhibitors (anti‐TNF) has a risk of activating latent tuberculosis infection (LTBI). This study was performed to investigate LTBI according to tuberculin skin test (TST) size and to determine the frequency of tuberculosis (TB) in bacillus Calmette‐Guerin (BCG)‐vaccinated children receiving anti‐TNF treatment for rheumatological disease. Materials and Methods The study consisted of 559 children. Information on demographics, anti‐TNF agents, TST size, and isoniazid (INH) prophylaxis was recorded. Patients (n = 254) with TST size ≥5 mm were divided into three groups according to TST size and INH prophylaxis: group 1, TST size 5 to 9 mm and no INH prophylaxis; group 2, TST size 5 to 9 mm with INH prophylaxis; and group 3, TST size ≥10 mm with INH prophylaxis. Results The 559 patients comprised 314 (56.3%) females and 245 (43.6%) males; they had a mean age of 13.1 ± 4.1 years. The mean TST size in all patients was 4.2 ± 4.7 mm. Group 1 consisted of 76 (29.9%) patients, group 2 consisted of 88 (34.6%) patients, and group 3 consisted of 90 (35.4%) patients. The mean TST sizes for the three groups were 6.8 ± 3.1 mm, 7.2 ± 3.2 mm, and 13.9 ± 2.8 mm, respectively. New TB was diagnosed in only two (0.35%) patients. Both of them were in group 3. Conclusions A TST size of ≥10 mm in BCG‐vaccinated children receiving anti‐TNF treatment may distinguish children at high risk for reactivation of LTBI.

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Section: Discussionmentioning

confidence: 94%

Determination of tuberculin skin test for isoniazid prophylaxis in BCG vaccinated children who are using anti‐TNF agents for rheumatologic diseases

Kılınç

Önal

Öztosun

et al. 2020

Pediatric Pulmonology

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“…On the contrary, meta-analyses evaluating patients treated with adalimumab, etanercept, infliximab, rituximab, abatacept, and anakinra concluded that the risk of severe infection did not increase (8-10). In the study by Alaşan et al 11 conducted in Türkiye, it was reported that TB developed in 2 cases (1.8%) due to the use of etanercept and infliximab among 110 patients who were under anti-TNF therapy. Since mycobacterial infections have been reported very rarely in patients receiving rituximab, there is no recommendation to screen for latent TB before using rituximab treatment (12).…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in patients using biological disease-modifying antirheumatic drugs

Afşin,

Küçük,

Taşçı

2023

Northwestern Med J

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Aim: In rheumatic diseases, the possibility of developing tuberculosis (TB) increases due to both the disease itself and the biological disease-modifying antirheumatic drugs (bDMARDs) used for treatment. In our study, we aimed to investigate the causes and risk factors of TB infection in patients using bDMARDs for rheumatological diseases.Methods: Demographic, radiological, laboratory data, tuberculin skin test (TST) results, duration of disease, and medications used in TB patients were recorded in 531 patients who were using bDMARD with the diagnosis of rheumatologic disease.Results: TB developed in 5 (0.9%) of 531 patients. TB was detected in 10% of the anakinra users, 2.4% of the infliximab users, 1.4% of the certolizumab users, 1.2% of the etanercept users, and 0.9% of the adalimumab users. The mean duration of bDMARD use until TB development was 28 months. All the cases were female, and the mean age was 53.8 years.Conclusion: Our study highlights the importance of routine chest X-ray, cervical-supraclavicular lymphadenopathy (LAP) examination, annual TST follow-up, and symptom questioning in TST-negative or anergic patients using bDMARDs.

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Etanercept/infliximab/isoniazid

2021

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Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test?

Abstract: Annakkaya (2020) Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test?, The Aging

Cited by 3 publications

References 25 publications

Determination of tuberculin skin test for isoniazid prophylaxis in BCG vaccinated children who are using anti‐TNF agents for rheumatologic diseases

Determination of tuberculin skin test for isoniazid prophylaxis in BCG vaccinated children who are using anti‐TNF agents for rheumatologic diseases

Tuberculosis in patients using biological disease-modifying antirheumatic drugs

Etanercept/infliximab/isoniazid

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