ArticleClinical rheumatology2021
Tuberculosis despite latent infection screening and treatment in patients receiving TNF inhibitor therapy.
Article in Clinical rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Regional risk ofFrontiers in pharmacology · 2023Pooled it
- Minimizing missed latent tuberculosis infection under adalimumab: real-world data from a BCG-vaccinated cohort.Clinical rheumatology · 2026Article
- Hepatotoxicity Risk of Isoniazid in Patients with Autoimmune Rheumatic Diseases and Prior Liver Injury Due to Disease-Modifying Antirheumatic Drugs: A Single-Center Experience and Literature Review.Journal of clinical medicine · 2026Article
- Monitoring of Patients Receiving Immunosuppressive and Biological Agent Treatments for Infectious Complications.Infectious diseases & clinical microbiology · 2025Article
- 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
- Frequency of tuberculosis in psoriasis patients using anti-TNF therapy during 16 years of follow-up.Postepy dermatologii i alergologii · 2025Article
- Effectiveness of tuberculosis preventive treatment in patients with rheumatic diseases: a global systematic review and meta-analysis.EClinicalMedicine · 2025Article
- The Resurgence of Tuberculosis: Causes and Global Perspectives.Journal of clinical practice and research · 2024Article
- Increased susceptibility to pneumonia due to tumour necrosis factor inhibition and prospective immune system rescueFrontiers in cellular and infection microbiology · 2022Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough latent tuberculosis infection (LTBI) treatment is given before anti-tumor necrosis factor (TNF) treatment, tuberculosis (TB) still develops in these patients and the risk factors are not well known. Besides, there is little data on the safety of isoniazid (INH) treatment in this group of patients. This study aimed to determine the risk factors for the development of tuberculosis and the safety of LTBI in such patients.
methodsAll patients (n=665) given anti-TNF in a single center were included in this study. Complete data were obtained from the records of 389 patients.
resultsSeven patients (1.1%) were diagnosed with TB. There was no significant difference in age, gender, smoking rate, comorbidities, leukocyte counts, hemoglobin, creatinine, AST, ALT, protein levels, and tuberculin reaction between patients with and without TB. Of 389 patients, 289 (76%) had received INH prophylaxis, including 43 tuberculin-negative patients. Thirty patients had anti-TNF use prior to INH prophylaxis. None of these patients had TB in the follow-up period. Seven patients who developed TB had completed LTBI treatment, including one patient who was tuberculin-negative. The time from the completion of INH treatment to the diagnosis of TB was 6-61 months. None had any history of contact with TB during this period. INH treatment was associated with hepatotoxicity in 49 patients (17%); all resolved without any need to stop INH.
conclusionPatients on anti-TNF treatment had a high rate of TB despite INH prophylaxis, but no risk factor for TB development was identified. Mild hepatotoxicity frequently developed during LTBI treatment. Key Points • Tuberculosis still develops in patients treated with tumor necrosis factor (TNF)-inhibitors despite prior screening and treatment for latent tuberculosis infection (LTBI). • In this cohort, all patients in whom tuberculosis developed had been treated for LTBI and all but one were initially tuberculin-positive. No risk factors have been identified. • The current policy of treating tuberculin-positive patients with a 9-month INH regimen does not seem to be fully effective in preventing tuberculosis.
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