Is it safe to use anti-TNF-α agents for tuberculosis in children suffering with chronic rheumatic disease?
Autor: | Yildiz Camcioglu, Nil Arisoy, Haluk Cokugras, Ozgur Kasapcopur, Omer Kilic, Necla Akçakaya |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Tuberculosis Adolescent Turkey Immunology Tuberculin Arthritis Comorbidity Antibodies Monoclonal Humanized Receptors Tumor Necrosis Factor Etanercept Young Adult Rheumatology Latent Tuberculosis Rheumatic Diseases Internal medicine medicine Adalimumab Humans Immunology and Allergy Child Retrospective Studies Latent tuberculosis Tuberculin Test Tumor Necrosis Factor-alpha business.industry Incidence Arthritis Psoriatic Antibodies Monoclonal medicine.disease Arthritis Juvenile Infliximab Surgery Treatment Outcome Child Preschool Immunoglobulin G Female Radiography Thoracic business Follow-Up Studies medicine.drug |
Zdroj: | Rheumatology International. 32:2675-2679 |
ISSN: | 1437-160X 0172-8172 |
Popis: | To determine the incidence of latent tuberculosis infection and evaluate the follow-up protocol of the patients diagnosed with juvenile idiopathic arthritis (JIA) and other chronic rheumatologic diseases treated with anti-TNF-α treatment (etanercept, infliximab, adalimumab) in Turkey, 144 patients were evaluated retrospectively for the development of tuberculosis. Patients were evaluated every 6 months for tuberculosis using history, physical examination, tuberculin skin test (TST), chest radiographs, and, when required, examination of sputum/early morning gastric aspirates for acid-fast bacilli and chest tomography. A tuberculin skin test over 10 mm induration was interpreted as positive. Patients were diagnosed with JIA (n = 132), enthesitis-related arthritis (ERA; n = 14), juvenile psoriatic arthritis (JPsA; n = 4), chronic idiopathic uveitis (n = 4), and chronic arthritis related to FMF (n = 8). Mean age was 12.25 ± 3.96 years (4.08-19.41 years), mean duration of illness was 5.86 ± 3.77 years (0.66-15 years), and the mean duration of anti-TNF-α treatment was 2.41 ± 1.47 years (0.6-7 years). Anti-TNF-α agents prescribed were etanercept (n = 133), infliximab (n = 30), and adalimumab (n = 6). When unresponsive to one anti-TNF-α therapy, patients were switched to another. There was no history of contact with individuals having tuberculosis. During follow-up, seven patients (4.8%) with positive TST were given INH prophylaxis. One oligoarticular JIA patient (0.69%) diagnosed with secondary uveitis who had been followed for 5 years and had been using infliximab for 2 years, developed a positive Quantiferon-TB test while on INH prophylaxis. He was started on an anti-tuberculosis drug regimen. In conclusion, anti-TNF-α treatment in children with chronic inflammatory disease is safe. Follow-up every 6 months of children on anti-TNF-α treatment with respect to tuberculosis by the pediatric infectious disease department is important to prevent possible complications. |
Databáze: | OpenAIRE |
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