ArticlePloS one2019
A population-based study of tuberculosis incidence among rheumatic disease patients under anti-TNF treatment.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis 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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- 2024 Update of the Asia-Pacific League of Associations for Rheumatology (APLAR) Recommendations for Rheumatoid Arthritis Management.International journal of rheumatic diseases · 2026Guideline
- Tuberculosis after allogeneic hematopoietic stem cell transplantation: a decade nationwide case-control retrospective study in low-incidence country.Bone marrow transplantation · 2026Article
- Lung Function Parameters during Anti-TNFα Therapy in Inflammatory Bowel Disease.The open respiratory medicine journal · 2026Article
- Observational
- Incidence rates of tuberculosis and inflammatory bowel disease in patients with ankylosing spondylitis treated with biologics in Korea.Rheumatology (Oxford, England) · 2025Article
- Frequency of tuberculosis in psoriasis patients using anti-TNF therapy during 16 years of follow-up.Postepy dermatologii i alergologii · 2025Article
- Medical Ozone Increases Methotrexate Effects in Rheumatoid Arthritis Through a Shared New Mechanism Which Involves Adenosine.International journal of molecular sciences · 2025Review
- Roles of Immunity and Endogenous Retroelements in the Pathogenesis of Rheumatoid Arthritis and Treatment Strategies.Functional & integrative genomics · 2025Review
- Effectiveness of tuberculosis preventive treatment in patients with rheumatic diseases: a global systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Tuberculosis Under Biotherapy in Patients with Spondyloarthritis: Data from the Moroccan Biotherapy Registry (RBSMR) during 3 Years of Follow Up.Mediterranean journal of rheumatology · 2025Article
- Preclinical evaluation of ELP-004 in mice.Pharmacology research & perspectives · 2024Article
- Tuberculosis and Nontuberculous Mycobacterial Infections in Patients with Spondyloarthritis: A Population-Based Study.Medicina (Kaunas, Lithuania) · 2024Article
- Extracorporeal photopheresis reduces inflammation and joint damage in a rheumatoid arthritis murine model.Journal of translational medicine · 2024Article
- Disseminated tuberculosis following negative QuantiFERON-TB gold tests during infliximab therapy: Implications for screening of hidradenitis suppurativa.JAAD case reports · 2022Article
- Treatment of Autoimmune Diseases with Therapeutic Antibodies: Lessons Learned from PID Patients Allow for Stratification of the Infection Risk.Methods in molecular biology (Clifton, N.J.) · 2022Article
- Orphan Nuclear Receptor NR4A2 Is Constitutively Expressed in Cartilage and Upregulated in Inflamed Synovium From hTNF-Alpha Transgenic Mice.Frontiers in pharmacology · 2022Article
- Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs.Mediterranean journal of rheumatology · 2021Article
- Management of Rheumatoid Arthritis: An Overview.Cells · 2021Review
- Reactivation of latent tuberculosis with TNF inhibitors: critical role of the beta 2 chain of the IL-12 receptor.Cellular & molecular immunology · 2021Review
- The Role of Tumor Necrosis Factor Alpha (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics.International journal of molecular sciences · 2021Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. The advent of immunobiologic therapy with TNF inhibitors agents, has been associated with a significant increase in incident cases of tuberculosis in this population.
objectiveTo estimate the incidence of tuberculosis in patients receiving TNF inhibitors therapy for rheumatic diseases. As secondary objectives, we sought to evaluate mortality and the clinical impact of screening for latent tuberculosis infection.
methodsThis retrospective study included patients with rheumatic diseases of Public Health System from the Brazilian state, a high TB incidence area, who received prescriptions of TNF inhibitors agents between 2006 and 2016.
resultsA total of 5853 rheumatic disease patients were included. Patients were predominantly women (68.7%) aged 49.5 (± 14.7) years old. Forty-three cases of TB were found (2.86 cases per 1000 person-years; 18 times higher than in the general population). Adalimumab and certolizumab users presented a higher risk for TB development compared to etanercept users (RR: 3.11, 95%CI 1.16-8.35; 7.47, 95%CI 1.39-40.0, respectively). In a subgroup of patients, screening for latent tuberculosis infection was performed in 86% of patients, and 30.2% had a positive tuberculin skin test. Despite latent TB treatment, TB was diagnosed in 2 out of 74 (2.7%) patients. Overall, TB diagnosis did not increase mortality.
conclusionIn this population-based study of rheumatic disease patients from a high incident area, TNF inhibitor exposure was associated with an 18-time increased TB incidence. Adalimumab and certolizumab were associated with greater and earlier TB diagnosis compared to etanercept.
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