Tuberculosis and tumour necrosis factor-α inhibitor therapy: a report of three cases in patients with psoriasis. Comprehensive screening and therapeutic guidelines for clinicians

Perlmutter, Amy; Mittal, Anmol; Menter, Alan

doi:10.1111/j.1365-2133.2008.08891.x

Cited by 40 publications

(41 citation statements)

References 28 publications

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“…Tuberculosis screening before anti-TNFα therapy has been recommended by the US Centers for Disease Control and Prevention, the American Thoracic Society, and the British Thoracic Society, 9 because anti-TNFα agents may increase of the risk of tuberculosis. 10 It has been reported that specific diseases, including IBD and rheumatoid arthritis, contribute to the increased incidence of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Ogata

Watanabe

Matsui

et al. 2016

ECCOJC

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Background and Aims:Data from an all-cases post-marketing study were used to evaluate the safety and effectiveness of adalimumab in Japanese patients with Crohn’s disease [CD].Methods:Patients received adalimumab for 24 weeks. Data from all patients [n = 1693] were used for the safety assessment. Data from patients with CD activity index [CDAI] ≥ 150 at baseline were used for the effectiveness assessment.Results:The most frequent serious adverse drug reaction [ADR] was infection and infestations [6.6 events/100 patient-years]. The risk of serious infections increased in patients who had a history of malignancy and those with concomitant corticosteroid use. Of 415 patients who had switched from another anti-tumour necrosis factor alpha [TNFα] agent to adalimumab due to ADRs, 7.2% discontinued due to ADRs to adalimumab. Ten of 13 patients with a history of tuberculosis [TB] received prophylactic medication, and none developed TB. TB developed in one patient with no history of TB or anti-TB prophylaxis. Remission rates were 41.3% and 32.4% at 4 and 24 weeks, respectively. Remission rates did not differ between patients with and without concomitant use of immunomodulators. Predictive variables for increased effectiveness were CDAI ≤ 220 and disease duration of ≤ 2 years. Perianal lesions and loss of response to previous anti-TNFα agents affected effectiveness.Conclusions:The most frequent serious ADR was infection. Adalimumab significantly reduced disease activity, without any unexpected ADRs. Development of active TB during adalimumab therapy can be prevented through TB screening and prophylaxis. In patients who switched from another anti-TNFα agent to adalimumab due to ADRs, adalimumab was well tolerated.

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Section: Discussionmentioning

confidence: 99%

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Ogata

Watanabe

Matsui

et al. 2016

ECCOJC

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“…It is possible to restart after 2 months, 28 but it is mandatory to pay close attention to TB evolution during follow-up. 29 …”

Section: Discussionmentioning

confidence: 99%

Lethal disseminated tuberculosis in patients under biological treatment – two clinical cases and a short review

et al. 2018

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Tumour necrosis factor (TNF)-α inhibitors are highly used in Romania for the treatment of autoimmune disorders, such as rheumatoid arthritis (RA), psoriasis, inflammatory bowel diseases, and ankylosing spondylitis. Biological therapy using TNF-α inhibitors is very effective but is associated with an increased risk of opportunistic infections, including active tuberculosis. Here, two cases are presented of patients with RA and psoriasis under biological therapy who developed very aggressive forms of disseminated tuberculosis, with a rapid progression to death. The authors conclude that patients undergoing biological therapy require thorough evaluation prior to initiating treatment, followed by continuous and rigorous monitoring by a multidisciplinary team during biological treatment, particularly in countries with a high incidence of tuberculosis.

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“…Society guidelines have suggested annual tuberculosis screening, with either TST or TIGRA, in patients on anti-TNF therapy. 21 While most patients with TB on anti-TNF therapy appear to have reactivation of latent disease, there are cases of new infection later in therapy. 20 However, the efficacy and accuracy of repeat annual testing has not been tested prospectively.…”

Section: Laboratory Examinations Tuberculin Skin Test (Tst)mentioning

confidence: 99%

General health maintenance in IBD

Moscandrew

Kane

2009

Inflammatory Bowel Diseases

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Patients with inflammatory bowel disease (IBD) often rely on their gastroenterologist for healthcare maintenance. In addition, the gastroenterologist also provides guidance to the patient's primary care physician on a broad range of issues such as vaccinations, osteoporosis screening, and cancer/dysplasia surveillance. Appropriate vaccinations should be administered to patients with IBD, particularly those likely to receive immunosuppression. Live virus vaccines are not appropriate for patients on immunosuppressive therapy, and therefore should be anticipated and given prior to initiating immunosuppression. Screening for osteoporosis is based on a combination of individual risk factors, but a history of prolonged (>3 months) steroid use over 10 mg is reason enough to obtain dual-energy x-ray absorptiometry scanning. Smoking cessation also falls within the realm of the gastroenterologist, as current smoking has a negative impact on Crohn's disease and cessation can be related to exacerbation in ulcerative colitis. Cancer screening includes not only colorectal cancer, but discussion regarding cervical dysplasia, skin cancer, and prostate cancer. Other primary care issues include hypertension and cholesterol monitoring, depression, and ocular health. A comprehensive understanding of all of the issues that can affect a patient with IBD throughout their life cycle is important, as it can impact their natural history, medication decisions, and overall outcomes.

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Tuberculosis and tumour necrosis factor-α inhibitor therapy: a report of three cases in patients with psoriasis. Comprehensive screening and therapeutic guidelines for clinicians

Cited by 40 publications

References 28 publications

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Lethal disseminated tuberculosis in patients under biological treatment – two clinical cases and a short review

General health maintenance in IBD

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