Incidence of Active Tuberculosis within One Year after Tumor Necrosis Factor Inhibitor Treatment according to Latent Tuberculosis Infection Status in Patients with Inflammatory Bowel Disease.
10.3346/jkms.2018.33.e292
- Author:
Jieun KANG
1
;
Dae Hyun JEONG
;
Minkyu HAN
;
Suk Kyun YANG
;
Jeong Sik BYEON
;
Byong Duk YE
;
Sang Hyoung PARK
;
Sung Wook HWANG
;
Tae Sun SHIM
;
Kyung Wook JO
Author Information
1. Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. heathcliff6800@hanmail.net
- Publication Type:Original Article
- Keywords:
Tuberculosis;
Inflammatory Bowel Disease;
TNF Inhibitor
- MeSH:
Crohn Disease;
Humans;
Incidence*;
Inflammatory Bowel Diseases*;
Interferon-gamma Release Tests;
Latent Tuberculosis*;
Mass Screening;
Skin Tests;
Tertiary Care Centers;
Thorax;
Tuberculin;
Tuberculosis*;
Tumor Necrosis Factor-alpha*
- From:Journal of Korean Medical Science
2018;33(47):e292-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We investigated the incidence of active tuberculosis among patients with inflammatory bowel disease (IBD) treated with tumor necrosis factor (TNF) inhibitors, with or without latent tuberculosis infection (LTBI). METHODS: The study was performed at a Korean tertiary referral center between January 2011 and June 2017. In total, 740 patients with IBD who underwent LTBI screening tests and were followed-up for ≥ 1 year after TNF inhibitor treatment initiation were enrolled. LTBI was detected on the basis of tuberculin skin test results, interferon-gamma release assay results, chest X-ray findings, and previous tuberculosis treatment history. The patients were classified into LTBI (n = 84) or non-LTBI (n = 656) group. The risk of developing tuberculosis in each group was assessed on the basis of standardized incidence ratio (SIR) and 95% confidence interval (CI) for active tuberculosis. RESULTS: Mean patient age was 33.1 years, and patients with Crohn's disease were predominant (80.7%). Within 1 year after the initiation of TNF inhibitor treatment, 1 patient in the LTBI group (1/84; 1.2%) and 7 patients in the non-LTBI group (7/656; 1.1%) developed active tuberculosis. The overall 1-year incidence of tuberculosis among the patients was significantly higher than that among the general population (SIR, 14.0; 95% CI, 7.0–28.0), and SIR was not affected by LTBI status (LTBI group: 14.5, 95% CI, 2.0–102.6; non-LTBI group: 14.0, 95% CI, 6.7–29.4). CONCLUSION: Patients with IBD undergoing TNF inhibitor treatment showed a higher 1-year incidence of tuberculosis than the general population irrespective of LTBI status.
