Abstract
Aim: The aim of study is to investigate the incidence of tuberculosis during the treatment in patients taking anti-tumor necrosis factor alpha (anti TNF-α).
Material/Method: The patients with rheumotoid arthritis,ankylosing spondylitis,jeuvenil rheumotoid arthritis or psoriatic arthiritis who were planned to treat with anti TNF-α or taking anti TNF-α therapy and sent to our pulmonary diseases outpatient clinic between July 2007-February 2010 were included in this study.PPD tests and chest X-rays were evaluated.Chest x-rays were examined for tuberculous sequelea and the patients suspicious for tuberculous sequelea were asked for contact with a tuberculosis case,physical examinations were done and their sputum was examined for acid-fast bacilli.
Results: Two hundred and twenty patients were included in the study.Anti TNF-α therapy was given the first time in 168 patients.Fifty two patients were already taking anti TNF-α therapy and directed to our outpatient clinic for follow-up.One hundred seventy nine patients were followed up regularly,41 patients did not continue follow-up and were excluded.Median follow-up period was 17 months (max: 31; min: 3 months). Two patients were diagnosed as tuberculosis during antiTNF-α therapy.
Conclusion: According to the data of ministry of health,the incidence of tuberculosis is 0.0026% in our country.In our study it is estabilished as 1.1%.When compared with the community,the incidence of tuberculosis is increased with antiTNF-α therapy.The blockade of TNF which one of the fundamental cytokins in human defense system leads to an increase in tuberculosis infection.The patients who were planned to treat with anti TNF-α should be monitored closely for tuberculosis during the treatment.
- © 2011 ERS
