The Tuberculosis Positive Conversion Rate Among Psoriasis Patients Treated with Adalimumab and Secukinumab: A Single-Center Retrospective Study in China

Abstract

Introduction The tuberculosis (TB) positive conversion rate among psoriasis patients who received biologics has been reported worldwide, particularly in regions with low TB risk. Nonetheless, the TB-related safety of biologics such as adalimumab and secukinumab remains elusive in areas with high TB risk. According to the World Tuberculosis Report 2021, China is the country with the second highest TB burden, but data on TB conversion are also limited. Thus, we performed a retrospective, single-center study to profile the TB infection status conversion ratio among psoriasis patients treated with adalimumab and secukinumab in China. Methods Patients were enrolled between April 2019 and February 2021 from West China Hospital, Sichuan University. Baseline and relevant clinical information were summarized, and proper statistical analysis was used under different conditions. Results Five (5.43%) patients suffered TB conversion in the adalimumab group, two of whom developed active TB within the first 6 months. In the secukinumab group, four (5.26%) patients had TB positive conversion with no reports of active TB. Conclusion Our data show a relatively high rate of TB conversion among these psoriasis patients after mean treatment duration of 17.13 months. We recommend that, in patients who receive adalimumab, TB be reevaluated after the first 3 months and then monitored semiannually for the next 2 years. For patients treated with secukinumab, annual examination is sufficient.

Evaluation of serial Quantiferon-TB gold in tube test results and tuberculosis infection status in patients with psoriasis receiving anti IL-17 treatment (secukinumab and ixekizumab): a real world data from a tuberculosis endemic country

“…[29] In various case series, no LTBI reactivation was observed in patients with LTBI who used SEC due to psoriasis and did not receive anti-TB prophylaxis. [30][31][32][33] To our knowledge, active TB infection under SEC treatment has been reported in only one case in the literature, a 19-year-old male from Vietnam (a country with a high TB burden) who used SEC for peripheral spondyloarthritis. The patient's symptoms improved with discontinuation of SEC and anti-TB treatment.…”

A Propensity Score-Matched Study on the Changes of TB Status and TB-IGRA Values in Patients with Psoriasis with Latent TB Receiving Secukinumab

“…Indeed, it has been confirmed that receiving TNFi, particularly anti-TNFα monoclonal antibodies, was one of the high-risk groups for developing active TB [ 18 ]. In 2022, our team also showed that two patients with psoriasis (2.17%, 2/92) with baseline IGRA negative results suffered active TB during follow-up in the high-burden region [ 19 ]. Previous research has indicated that prophylactic therapy can reduce the risk of developing active TB in such a high-risk group, and isoniazid monotherapy is 60–90% effective for 6–12 months [ 15 ].…”