ArticlePloS one2016
Different Risk of Tuberculosis and Efficacy of Isoniazid Prophylaxis in Rheumatoid Arthritis Patients with Biologic Therapy: A Nationwide Retrospective Cohort Study in Taiwan.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Prevalence and risk of chronic obstructive pulmonary disease in rheumatoid arthritis: Systematic review and meta-analysis.Medicine · 2026Pooled it
- Diabetes as a risk factor for tuberculosis disease.The Cochrane database of systematic reviews · 2024Pooled it
- Regional risk ofFrontiers in pharmacology · 2023Pooled it
- Incidence of tuberculosis in patients receiving anti-TNF therapy for rheumatic diseases: a systematic review.Clinical rheumatology · 2020Pooled it
- Chronic obstructive pulmonary disease in rheumatoid arthritis: a systematic review and meta-analysis.Respiratory research · 2019Pooled it
- Effectiveness of tuberculosis preventive treatment in patients with rheumatic diseases: a global systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Disseminated tuberculosis after Polatuzumab-Vedotin based chemoimmunotherapy in a patient with Burkitt's lymphoma.Clinical case reports · 2024Article
- Drugs Targeting CD20 in Multiple Sclerosis: Pharmacology, Efficacy, Safety, and Tolerability.Drugs · 2024Review
- TWEAK-Fn14 Axis Induces Calcium-Associated Autophagy and Cell Death To Control Mycobacterial Survival in Macrophages.Microbiology spectrum · 2022Article
- Opposing Trends in Total Knee and Hip Arthroplasties for Patients With Rheumatoid Arthritis vs. the General Population-A 14-Year Retrospective Study in Taiwan.Frontiers in medicine · 2021Article
- Incident tuberculosis disease in patients receiving biologic therapies in the Western Cape, South Africa from 2007 to 2018.BMC infectious diseases · 2020Article
- Tuberculosis Arthritis in the Wrist While Using Rituximab for Rheumatoid Arthritis Treatment.Open access rheumatology : research and reviews · 2020Article
- Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors.Therapeutic advances in musculoskeletal disease · 2020Review
- Gaps in Ambulatory Patient Safety for Immunosuppressive Specialty Medications.Joint Commission journal on quality and patient safety · 2019Article
- Article
- High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India.Intestinal research · 2018Article
- Infectious Complications of Multiple Sclerosis Therapies: Implications for Screening, Prophylaxis, and Management.Open forum infectious diseases · 2018Review
- B Cells Producing Type I IFN Modulate Macrophage Polarization in Tuberculosis.American journal of respiratory and critical care medicine · 2018Article
- The impact of cancer development on the risk of mycobacterial diseases among rheumatoid arthritis patients.Epidemiology and infection · 2017Article
- Peritoneal tuberculosis in the setting of ustekinumab treatment for psoriasis.JAAD case reports · 2017Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Increasing evidence indicates an increased risk of tuberculosis (TB) for rheumatoid arthritis (RA) patients receiving biologic therapy, and the effectiveness of isoniazid prophylaxis (INHP) in TB prevention. We aimed to examine 1) the incidence rate (IR) and risk factors for TB among RA patients receiving different therapies; 2) INHP effectiveness for TB prevention; 3) mortality rates after TB diagnosis in patients receiving different therapies. This retrospective study was conducted using a nationwide database: 168,720 non-RA subjects and a total of 42,180 RA patients including 36,162 csDMARDs-exposed, 3,577 etanercept-exposed, 1,678 adalimumab-exposed and 763 rituximab-exposed patients. TB risk was 2.7-fold higher in RA cohort compared with non-RA group, with an adjusted hazard ratio (aHR) of 2.58. Advanced age, male, the use of corticosteroids ≧ 5 mg/day, and the presence of diabetes mellitus (DM), chronic obstructive pulmonary disease and chronic kidney disease were risk factors for developing TB. Using csDMARDs-exposed group as reference, aHR of TB was the highest with adalimumab treatment (1.52), followed by etanercept (1.16), and the lowest with rituximab (0.08). INHP could effectively reduce TB risk in biologics-exposed patients. Mortality rates after TB diagnosis were higher in RA patients, particularly the elderly and those with DM, with lower rates in adalimumab-exposed patients compared with csDMARDs-exposed patients. In conclusion, TB risk was increased in patients receiving TNF-α inhibitors, but the risk associated with rituximab therapy was relatively low. With the effectiveness of INHP shown in the prevention of biologics-associated TB, stricter implementation of INHP should be beneficial. The mortality from biologics-associated TB may be efficiently reduced through increased awareness.
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