Abstract
Aim:There are studies on smoking increases the risk of tuberculosis(TB),but this relationship is unclear.TNF-α inhibitors used in the treatment of various immune-related diseases,and are known to increase the risk of development TB.In this study,we investigated the effect of smoking habit on the risk of TB in patients under the anti-TNF-α treatment.
Method:Between October 2003 and January 2013,in accordance with the criteria of RAED II Consensus Report of TNF-α inhibitors in total 2930 patients with various diagnoses were retrospectively evaluated.Smoker and nonsmoker patients were compared according to risk of TB. Statistical analysis was done by using SPSS15.0 software.
Results:1494(%51) patients were male, 1436(%49) were female, mean age was 40,1±14,4 years. At admision the distribution of primary diseases was: ankylosing spondylitis (n=1130, 36.8%), rheumatoid arthritis (n=951,32.0%), psoriatic arthritis (n=251,8.6%), juvenile rheumatoid arthritis (n=153,5.2%), Behcet’s disease (n=118,0.4%), Crohn disease (n=100,3.6%). 1279 patients (43.7%, male=856, female=423) were smoker (mean 15.2 ±13.3 packet-year). 10 patients (male=6, female=4) developed TB (341/100.000)[3 miliary TB,3 TB pleurisy,1 TB of ear,1 TB of intestine,2 pulmonary TB;8 patients of 10 TB cases (80%);and all of 5 extrapulmonary TB cases (100%) were smoker ]. TB was statistically significantly higher(P<0.05) in patients who are smoker.
Conclusion:The risk of tuberculosis especially extrapulmonary tuberculosis is increased in patients under anti-TNF-α treatment,this risk is higher in patients who are smoker.The patients using TNF-α inhibitors should be monitored closely for tuberculosis and encouraged for smoking cessation.
- © 2013 ERS