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Characteristics Predicting Tuberculosis Risk under Tumor Necrosis Factor-alpha Inhibitors: Report from a Large Multicenter Cohort with High Background Prevalence

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dc.contributor.authorDİRESKENELİ, RAFİ HANER
dc.contributor.authorsKisacik, Bunyamin; Pamuk, Omer Nuri; Onat, Ahmet Mesut; Erer, Sait Burak; Hatemi, Gulen; Ozguler, Yesim; Pehlivan, Yavuz; Kilic, Levent; Ertenli, Ihsan; Can, Meryem; Direskeneli, Haner; Keser, Gokhan; Oksel, Fahrettin; Dalkilic, Ediz; Yilmaz, Sedat; Pay, Salih; Balkarli, Ayse; Cobankara, Veli; Cetin, Gode Yildirim; Sayarlioglu, Mehmet; Cefle, Ayse; Yazici, Ayten; Avci, Ali Berkant; Terzioglu, Ender; Ozbek, Suleyman; Akar, Servet; Gul, Ahmet
dc.date.accessioned2022-03-12T20:30:27Z
dc.date.available2022-03-12T20:30:27Z
dc.date.issued2016
dc.description.abstractObjective. Screening strategies for latent tuberculosis (TB) before starting tumor necrosis factor (TNF)-alpha inhibitors have decreased the prevalence of TB among patients who are treated with these agents. However, despite vigilant screening, TB continues to be an important problem, especially in parts of the world with a high background TB prevalence. The aim of this study was to determine the factors related to TB among a large multicenter cohort of patients who were treated with anti-TNF. Methods. Fifteen rheumatology centers participated in this study. Among the 10,434 patients who were treated with anti-TNF between September 2002 and September 2012, 73 (0.69%) had developed TB. We described the demographic features and disease characteristics of these 73 patients and compared them to 7695 patients who were treated with anti-TNF, did not develop TB, and had complete data available. Results. Among the 73 patients diagnosed with TB (39 men, 34 women, mean age 43.6 +/- 13 yrs), the most frequent diagnoses were ankylosing spondylitis (n = 38) and rheumatoid arthritis (n = 25). More than half of the patients had extrapulmonary TB (39/73, 53%). Six patients died (8.2%). In the logistic regression model, types of anti-TNF drugs [infliximab (IFX), OR 3.4, 95% CI 1.88-6.10, p = 0.001] and insufficient and irregular isoniazid use (<9 mos; OR 3.15, 95% CI 1.43-6.9, p = 0.004) were independent predictors of TB development. Conclusion. Our results suggest that TB is an important complication of anti-TNF therapies in Turkey. TB chemoprophylaxis less than 9 months and the use of IFX therapy were independent risk factors for TB development.
dc.identifier.doi10.3899/jrheum.150177
dc.identifier.eissn1499-2752
dc.identifier.issn0315-162X
dc.identifier.pubmed26773107
dc.identifier.urihttps://hdl.handle.net/11424/234174
dc.identifier.wosWOS:000378167600010
dc.language.isoeng
dc.publisherJ RHEUMATOL PUBL CO
dc.relation.ispartofJOURNAL OF RHEUMATOLOGY
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectTUMOR NECROSIS FACTOR-A INHIBITORS
dc.subjectTUBERCULOSIS REACTIVATION
dc.subjectISONIAZID
dc.subjectRHEUMATOID-ARTHRITIS
dc.subjectFACTOR ANTAGONISTS
dc.subjectTHERAPY
dc.subjectTNF
dc.subjectMORTALITY
dc.subjectINFECTIONS
dc.subjectTERM
dc.titleCharacteristics Predicting Tuberculosis Risk under Tumor Necrosis Factor-alpha Inhibitors: Report from a Large Multicenter Cohort with High Background Prevalence
dc.typearticle
dspace.entity.typePublication
local.avesis.idc85bd0e4-3af4-44ed-8714-a10c3d2d060b
local.import.packageSS17
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages6
local.journal.quartileQ2
oaire.citation.endPage529
oaire.citation.issue3
oaire.citation.startPage524
oaire.citation.titleJOURNAL OF RHEUMATOLOGY
oaire.citation.volume43
relation.isAuthorOfPublication07a34d26-21f3-475d-bd36-152d6c659370
relation.isAuthorOfPublication.latestForDiscovery07a34d26-21f3-475d-bd36-152d6c659370

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