Tuberculosis in Anti-Tumour Necrosis Factor-treated Inflammatory Bowel Disease Patients After the Implementation of Preventive Measures: Compliance With Recommendations and Safety of Retreatment
Autor: | Carpio, D, Jauregui-Amezaga, A, de Francisco, R, de Castro, L, Barreiro-de Acosta, M, Mendoza, J L, Mañosa, M, Ollero, V, Castro, B, González-Conde, B, Hervías, D, Sierra Ausin, M, Sancho Del Val, L, Botella-Mateu, B, Martínez-Cadilla, J, Calvo, M, Chaparro, M, Ginard, D, Guerra, I, Maroto, N, Calvet, X, Fernández-Salgado, E, Gordillo, J, Rojas Feria, M, GETECCU |
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Rok vydání: | 2016 |
Předmět: |
Crohn’s disease
Adult Male medicine.medical_specialty Tuberculosis Tuberculin Opportunistic Infections Inflammatory bowel disease Anti-TNF 03 medical and health sciences 0302 clinical medicine prevention Interquartile range inflammatory bowel disease Internal medicine adalimumab Adalimumab medicine Humans ulcerative colitis Retrospective Studies 030203 arthritis & rheumatology Crohn's disease business.industry Tuberculin Test Gastroenterology General Medicine Middle Aged medicine.disease Inflammatory Bowel Diseases Ulcerative colitis Infliximab Surgery Treatment Outcome Spain Practice Guidelines as Topic Retreatment 030211 gastroenterology & hepatology Female Guideline Adherence business Immunosuppressive Agents medicine.drug Follow-Up Studies |
Zdroj: | Journal of Crohns & Colitis r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
ISSN: | 1876-4479 1873-9946 |
Popis: | Background and aims: Despite having adopted preventive measures, tuberculosis (TB) may still occur in patients with inflammatory bowel disease (IBD) treated with anti-tumour necrosis factor (anti-TNF). Data on the causes and characteristics of TB cases in this scenario are lacking. Our aim was to describe the characteristics of TB in anti-TNF-treated IBD patients after the publication of the Spanish TB prevention guidelines in IBD patients and to evaluate the safety of restarting anti-TNF after a TB diagnosis. Methods: In this multicentre, retrospective, descriptive study, TB cases from Spanish hospitals were collected. Continuous variables were reported as mean and standard deviation or median and interquartile range. Categorical variables were described as absolute and relative frequencies and their confidence intervals when necessary. Results: We collected 50 TB cases in anti-TNF-treated IBD patients, 60% male, median age 37.3 years (interquartile range [IQR] 30.4–47). Median latency between anti-TNF initiation and first TB symptoms was 155.5 days (IQR 88–301); 34% of TB cases were disseminated and 26% extrapulmonary. In 30 patients (60%), TB cases developed despite compliance with recommended preventive measures; *not performing 2-step TST (tuberculin skin test) was the main failure in compliance with recommendations. In 17 patients (34%) anti-TNF was restarted after a median of 13 months (IQR 7.1–17.3) and there were no cases of TB reactivation. Conclusions: Tuberculosis could still occur in anti-TNF-treated IBD patients despite compliance with recommended preventive measures. A significant number of cases developed when these recommendations were not followed. Restarting anti-TNF treatment in these patients seems to be safe. |
Databáze: | OpenAIRE |
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