RT Journal Article
SR Electronic
T1 Initiation of anti-TNF therapy within 3 weeks of LTBI treatment in patients with immune-mediated inflammatory diseases
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2684
VO 44
IS Suppl 58
A1 Yoomi Yeo
A1 Kyung-Wook Jo
A1 Sang-Do Lee
A1 Woo Sung Kim
A1 Dong Soon Kim
A1 Tae Sun Shim
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2684.abstract
AB OBJECTIVE: We investigated the incidence of tuberculosis (TB) among anti-tumor necrosis factor (TNF) users in accordance with the duration of preventive chemotherapy against latent TB infection (LTBI) before starting anti-TNF therapy.DESIGN: A total of 410 patients receiving LTBI treatment before commencing TNF antagonist therapy between June 2005 and October 2013 were retrospectively analyzed.RESULTS: The mean age of the 410 study subjects was 46 years and 261 (63.7%) were male. The underlying immune-mediated inflammatory disease (IMID) was ankylosing spondylitis in 203 (49.5%), rheumatoid arthritis in 136 (33.2%), inflammatory bowel diseases in 57 (13.9%) and other diseases in 14 (3.4%) patients.Tuberculin skin test and interferon-gamma release assay positivity were 60.3% (243/403) and 81.6% (314/380), respectively. Sixty one patients in the total cohort received TNF antagonist therapy within 3 weeks of commencing LTBI treatment and the remaining 349 patients received anti-TNF agents after more than 3 weeks of LTBI treatment. These two groups were comparable in terms of baseline characteristics, treatment regimens and follow-up duration but showed a statistically significant difference in the mean duration of LTBI treatment before starting anti-TNF therapy (8 vs. 30 days, p < 0.001). During follow-up (median, 31.6 months), none of the 61 who had received TNF antagonist therapy within 3 weeks of commencing LTBI treatment developed active TB, whereas 3 (0.9%) of the remaining 349 patients were diagnosed with active TB.CONCLUSIONS: TNF antagonist therapy may be initiated within 3 weeks of LTBI treatment in patients with IMIDs.