Safe Re-administration of Tumor Necrosis Factor-alpha (TNFalpha) Inhibitors in Patients with Rheumatoid Arthritis or Ankylosing Spondylitis Who Developed Active Tuberculosis on Previous Anti-TNFalpha Therapy.
10.3346/jkms.2014.29.1.38
- Author:
Young Sun SUH
1
;
Seung Ki KWOK
;
Ji Hyeon JU
;
Kyung Su PARK
;
Sung Hwan PARK
;
Chong Hyeon YOON
Author Information
1. Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. chyoon@catholic.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
TNFalpha Inhibitor;
Tuberculosis;
Arthritis, Rheumatoid;
Spondylitis, Ankylosing
- MeSH:
Adult;
Aged;
Anti-Inflammatory Agents, Non-Steroidal/adverse effects/therapeutic use;
Antibodies, Monoclonal/adverse effects/therapeutic use;
Antibodies, Monoclonal, Humanized/adverse effects/therapeutic use;
Antirheumatic Agents/adverse effects/therapeutic use;
Arthritis, Rheumatoid/*drug therapy;
Enzyme Inhibitors/adverse effects/therapeutic use;
Female;
Humans;
Hydroxychloroquine/adverse effects/therapeutic use;
Immunoglobulin G/adverse effects/therapeutic use;
Immunosuppressive Agents/adverse effects/*therapeutic use;
Interferon-gamma Release Tests;
Male;
Methotrexate/adverse effects/therapeutic use;
Middle Aged;
Mycobacterium tuberculosis/isolation & purification;
Receptors, Tumor Necrosis Factor/therapeutic use;
Retrospective Studies;
Spondylitis, Ankylosing/*drug therapy;
Tuberculin Test;
Tuberculosis/*chemically induced/microbiology;
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
- From:Journal of Korean Medical Science
2014;29(1):38-42
- CountryRepublic of Korea
- Language:English
-
Abstract:
There is no consensus on whether it is safe to re-administer tumor necrosis factor-alpha (TNFalpha) inhibitors in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) flared after withdrawal of TNFalpha inhibitors due to active tuberculosis (TB). We evaluated the safety of restarting anti-TNFalpha therapy in patients with TNFalpha-associated TB. We used data of 1,012 patients with RA or AS treated with TNFalpha inhibitors at Seoul St. Mary's Hospital between January 2003 and July 2013 to identify patients who developed active TB. Demographic and clinical data including the results of tuberculin skin tests (TST) and interferon-gamma releasing assays (IGRA) were collected. Fifteen patients developed active TB. Five cases were occurred in RA and 10 cases in AS. Nine of 15 patients had a negative TST or IGRA and 6 TST-positive patients had received prophylaxis prior to initiating anti-TNFalpha therapy. All patients discontinued TNFalpha inhibitors with starting the treatment of TB. Eight patients were re-administered TNFalpha inhibitors due to disease flares and promptly improved without recurrence of TB. TNFalpha inhibitors could be safely resumed after starting anti-TB regimen in patients with RA or AS.
