Tuberculosis and latent tuberculosis in children and adolescents with rheumatic diseases in a tertiary hospital in Rio de Janeiro – a prospective study

Abstract

Clinical and radiological diagnosis in TB cases were valuable and it is important to consider the disease as an adverse event in patients with rheumatic diseases, regardless of the drugs in use.

No seroconversion in a retrospective study analyzing QuantiFERON TB‐gold testing in pediatric psoriasis and hidradenitis suppurativa patients taking biologic therapy at an academic center in New York City

“…diseases, there were also no seroconverters, despite Spain having higher TB burden of 16.3 cases/100,000 people compared to 2.5/100,000 in the US and 6.4/100,000 in NYC. 3,4 Moreover, a literature review including 36,198 patients ages ≤19 years taking biologics for rheumatic diseases reported that only 7 (0.019%) patients seroconverted. 4 These low seroconversion rates could be explained by the rarity of TB in the pediatric population.…”

“…3,4 Moreover, a literature review including 36,198 patients ages ≤19 years taking biologics for rheumatic diseases reported that only 7 (0.019%) patients seroconverted. 4 These low seroconversion rates could be explained by the rarity of TB in the pediatric population. In the US, only 4% of TB cases occur in patients under 16 years old.…”

Screening, prophylaxis, and challenges: Tumor necrosis factor inhibitors and latent tuberculosis infection nexus in rheumatology

“…21 Although expert comments proposed that after proper LTBI screening, proactive TB therapy has been demonstrated to be effective and well-tolerated to reduce the risk of TB reactivation in RD patients requiring TNFi, 22 there are still case reports of TB reactivation and subsequent poor prognosis in patients with preventive treatment. 23 In addition, as mentioned earlier, LTBI screening before starting biological therapy may not always accurately identify patients at risk of TB reactivation, and the implementation of LTBI screening in RD being widely emphasized, 32% patients received neither TST/IGRA screening nor LTBI treatment before TNFi application. 24 On the other hand, the measurement of pretreatment biomarkers, such as inflammatory cytokine levels, is valuable for prediction of treatment efficacy to TNFi.…”

“…Compared to isoniazid/rifampicin monotherapy, combination therapy can shorten the treatment time and achieve higher treatment completion rates 21 . Although expert comments proposed that after proper LTBI screening, proactive TB therapy has been demonstrated to be effective and well‐tolerated to reduce the risk of TB reactivation in RD patients requiring TNFi, 22 there are still case reports of TB reactivation and subsequent poor prognosis in patients with preventive treatment 23 . In addition, as mentioned earlier, LTBI screening before starting biological therapy may not always accurately identify patients at risk of TB reactivation, and the implementation of LTBI screening in RD patients does not seem to be as well as expected.…”