SynthesisClinical rheumatology2020
Incidence of tuberculosis in patients receiving anti-TNF therapy for rheumatic diseases: a systematic review.
Synthesis in Clinical rheumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Regional risk ofFrontiers in pharmacology · 2023Pooled it
- The molecular mechanism of the adverse effects of the biological and small molecular drugs in the therapy of inflammatory skin diseases - psoriasis and atopic dermatitis.Annals of medicine · 2026Review
- Assessment of PPD Conversion Rate in Patients Receiving Tumor Necrosis Factor-alpha Inhibitor Drugs.Iranian journal of pathology · 2026Article
- Host-directed therapeutic targets in macrophages and their ligands against mycobacteria tuberculosis.Infection and immunity · 2025Review
- Risk of Latent Tuberculosis Infection Reactivation in Patients Treated with Tumor Necrosis Factor Antagonists: A Five-Year Retrospective Study.Tropical medicine and infectious disease · 2025Article
- Retrospective evaluation of active tuberculosis cases in terms of chemoprophylaxis indication: A cross-sectional study.Medicine · 2025Observational
- Abdominal tuberculosis in a patient with ankylosing spondylitis and infliximab: is the risk still too great? A case report.Journal of surgical case reports · 2025Article
- Tuberculin skin test repetition after TNF-α inhibitors in patients with chronic inflammatory arthritis: a long-term retrospective cohort in endemic area.Advances in rheumatology (London, England) · 2024Article
- Frequency of latent tuberculosis in patients receiving Anti-TNF-Alpha therapy.African health sciences · 2023Article
- Laryngeal tuberculosis in patients treated with adalimumab: a casual or causal connection?BMJ case reports · 2023Article
- Concomitant Use of Elexacaftor/Tezacaftor/Ivacaftor and Etanercept in a Cystic Fibrosis Patient with Juvenile Idiopathic Arthritis.Journal of clinical medicine · 2023Article
- Review
- TNF inhibitors increase the risk of nontuberculous mycobacteria in patients with seropositive rheumatoid arthritis in a mycobacterium tuberculosis endemic area.Scientific reports · 2022Observational
- 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
- Immunomodulatory Agents for Treatment of Patients with Inflammatory Bowel Disease (Review safety of anti-TNF, Anti-Integrin, Anti IL-12/23, JAK Inhibition, Sphingosine 1-Phosphate Receptor Modulator, Azathioprine / 6-MP and Methotrexate).Current gastroenterology reports · 2021Review
- Reactivation of latent tuberculosis with TNF inhibitors: critical role of the beta 2 chain of the IL-12 receptor.Cellular & molecular immunology · 2021Review
- Targeting Molecular Inflammatory Pathways in Granuloma as Host-Directed Therapies for Tuberculosis.Frontiers in immunology · 2021Review
- The Role of gp130 Cytokines in Tuberculosis.Cells · 2020Review
- Clinical Aspects of Janus Kinase (JAK) Inhibitors in the Cardiovascular System in Patients with Rheumatoid Arthritis.International journal of molecular sciences · 2020Review
- Is Takayasu arteritis the result of a Mycobacterium tuberculosis infection? The use of TNF inhibitors may be the proof-of-concept to demonstrate that this association is epiphenomenal.Clinical rheumatology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe TNF inhibitors were the first immunobiologicals used to treat rheumatic diseases, but their use is associated with an increased risk of tuberculosis. The primary objective is to estimate the incidence of tuberculosis in patients with rheumatic diseases exposed to anti-TNF therapy. The secondary objectives are to evaluate the incidence of tuberculosis by region and subgroups of diseases, to review the presentation of tuberculosis in these patients, and to assess the time elapsed between onset of anti-TNF therapy and development of active granulomatous disease.
methodsA systematic review of the literature was conducted in MEDLINE, the Cochrane Library, and LILACS. The primary endpoint was described as incidence and secondary outcomes, through subgroup analyses and comparisons of means.
resultsWe included 52 observational studies. Among the exposed patients, 947 cases of tuberculosis were documented (62.2% pulmonary), with a cumulative incidence of 9.62 cases per 1000 patients exposed. TB incidence across different continents was distributed as follows: South America, 11.75 cases/1000 patients exposed; North America, 4.34 cases/1000 patients exposed; Europe, 6.28 cases/1000 patients exposed; and Asia, 13.47 cases/1000 patients exposed. There were no significant differences in TB incidence among the described diseases. The mean time elapsed from start of anti-TNF therapy until the endpoint was 18.05 months.
conclusionThe incidence of TB in patients with rheumatic diseases exposed TNF inhibitor considering all countries was 9.62 cases per 1000 patients exposed. TB incidence was higher in South America and Asia compared with North America and Europe. Most cases occurred in the first XX months of use, and the pulmonary form predominated.Key Points• Higher incidence of tuberculosis in patients exposed to anti-TNF compared with the general population.• Higher incidence of TB in countries of South America and Asia compared with North America and Europe.
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