Diagnosis and Treatment of Latent Tuberculosis Infection in Arthritis Patients Treated with Tumor Necrosis Factor Antagonists in Korea.
10.3346/jkms.2007.22.5.779
- Author:
Jong Wook YUN
1
;
Seong Yong LIM
;
Gee Young SUH
;
Man Pyo CHUNG
;
Hojoong KIM
;
O Jung KWON
;
Hoon Suk CHA
;
Eun Mi KOH
;
Won Jung KOH
Author Information
1. Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wjkoh@skku.edu
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Spondylitis, Ankylosing;
Isoniazid;
Arthritis, Rheumatoid;
Rifampin;
Tuberculin Test;
Tuberculosis;
Tumor Necrosis Factor-alpha
- MeSH:
Adult;
Antibiotics, Antitubercular/pharmacology;
Arthritis, Rheumatoid/*complications/*diagnosis/*drug therapy;
Female;
Humans;
Korea;
Male;
Middle Aged;
Retrospective Studies;
Rifampin/pharmacology;
Spondylitis/metabolism;
Spondylitis, Ankylosing/complications/diagnosis/drug therapy;
Tuberculin Test;
Tuberculosis/*complications/*diagnosis/*drug therapy;
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
- From:Journal of Korean Medical Science
2007;22(5):779-783
- CountryRepublic of Korea
- Language:English
-
Abstract:
Tumor necrosis factor (TNF) is essential for host defense against Mycobacterium tuberculosis, and the risk of reactivation of latent tuberculosis infection (LTBI) increases with anti-TNF therapy. This study estimated the prevalence of LTBI and evaluated the safety and completion rate of short-course therapy with isoniazid plus rifampin for 3 months to treat LTBI in a cohort of Korean arthritis patients before initiating anti-TNF therapy. We retrospectively studied the files of 112 consecutive patients to evaluate LTBI before starting anti-TNF drugs. Screening tests were performed, including a tuberculin skin test and chest radiography. LTBI treatment was indicated in 41 patients (37%). Of these, three patients refused the LTBI treatment. Of the 38 patients who underwent LTBI treatment, 36 (95%) took isoniazid plus rifampin for 3 months. Six patients (16%) showed transient elevations of liver enzymes during the LTBI treatment. Overall, 35 patients (92%) completed the LTBI treatment as planned. In conclusion, LTBI was diagnosed in one-third of Korean arthritis patients before initiating anti-TNF therapy. A high percentage of these patients completed 3 months of LTBI treatment with isoniazid plus rifampin without serious complications.
