Tuberculosis reactivation during immunosuppressive therapy in rheumatic diseases: diagnostic and therapeutic strategies

Abstract

Findings to date support the close screening and treatment for tumor necrosis factor in this uniquely vulnerable group. Such vigilance should probably be applied to future drugs that interfere with cytokines known to play a role in tuberculosis immunity.

Gene engineering biological therapy for juvenile arthritis

“…Также вызывают обеспокоенность сепсис, ту-беркулез и оппортунистические инфекции. Поскольку блока-торы ФНО α, особенно моноклональные антитела (ИФ, АДА, голимумаб), препятствуют образованию гранулемы, они мо-гут активировать латентный туберкулез [121], поэтому до и во время такого лечения необходим скрининг на туберкулез [122][123][124]. FDA США призывает к бдительности медицинско-го персонала в плане риска оппортунистической грибковой инфекции у пациентов, получающих какие-либо из разре-шенных к применению анти-ФНО препаратов [125,126].…”

Nontuberculous Mycobacterium Infections in Rheumatoid Arthritis Patients

“…Chest radiography typically only detects diverse and partly species-specific patterns (Griffith et al, 2007); moreover, these features represent active NTM disease and cannot be used to identify early infection. Despite these difficulties, the number of NTM infections has recently exceeded that of TB (Winthrop et al, 2008), which may reflect improvements in the screening for latent TB infection (Arend et al, 2003;Beglinger et al, 2007;Carmona et al, 2005;Centers for Disease Control and Prevention, 2004;Keane & Bresnihan, 2008;Leding et al, 2005). Among the new drug classes developed for anti-RA therapy, anti-IL-17 and anti-IL-23 antibodies are particularly significant to NTM infections, as they have important roles in all stages of the immune response against mycobacterial infection, from neutrophil recruitment in early phases to granuloma formation and maintenance in later stages (Lubberts, 2008;McInnes & Liew, 2005).…”

Should Tuberculin Skin Test Be Positive to Give Latent Tuberculosis Treatment Before Tumor Necrosis Factor-α Inhibitors in Selected Patients in Developing Countries?: Table 1.

“…TB disease flares could be brought close to zero, or at least near 1% as quoted from randomized controlled trials of TNF-α inhibitor agents 10 .…”