| Title |
Risk of active tuberculosis in patients with inflammatory arthritis receiving TNF inhibitors: a look beyond the baseline tuberculosis screening protocol
|
|---|---|
| Published in |
Clinical Rheumatology, November 2017
|
| DOI | 10.1007/s10067-017-3916-y |
| Pubmed ID | |
| Authors |
Alina Soare, Ana Maria Gheorghiu, Victoria Aramă, Dragoș Bumbăcea, Rucsandra Dobrotă, Raida Oneaţă, Simona Pintilie, Mihaela Milicescu, Ioan Ancuţa, Andrei Martin, Mariana Sasu, Claudia Ciofu, Liviu Macovei, Victor Stoica, Mihai Bojincă, Carina Mihai |
| Abstract |
Tuberculosis (TB) is a major concern in patients receiving TNF inhibitors (TNFi). This study aimed to assess the incidence of active TB and the efficacy of TB prevention measures used over the years, and to determine risk factors for developing TB, in a single-centre cohort of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) receiving TNFi. Data of all patients in whom treatment with TNFi was initiated in our rheumatology clinic until December 1st 2014 have been retrospectively analysed. The cohort was divided into 3 groups per the mandatory LTBI screening method at baseline: tuberculin skin test (TST) with a positive threshold of either 10 mm (group TST1), or 5 mm (group TST2), and QuantiFERON®-TB Gold test (group QFT). The incidence of active TB was analysed for each group and compared to TB incidence data in general population. Five hundred fifty patients were included (305 RA, 42 PsA, 203 AS); 97 patients belonged to the TST1, 229 to the TST2 and 224 to the QFT group. The number of active TB cases/time of exposure to TNFi (person-years, PY) was 8/593.5, 9/1044.0 and 3/555.3, respectively, accounting for an incidence of 1348.0, 862.1 and 540.2 cases per 105 PY. Active TB cases occurring in the first year of TNFi treatment (early TB) per total TB cases were only 3/8, 1/9 and 1/3, respectively, too few to identify statistically significant differences between the 3 LTBI screening protocols. However, less TB cases per total observation time were registered in the QFT group, probably due to the reduced duration of exposure to TNFi. All cases of active TB were registered among patients receiving monoclonal antibodies TNFi agents. We have found no significant risk factors for developing active TB. In our cohort, TB occurring after 1 year of TNFi treatment exceeds 'early TB', suggesting the necessity of further TB prevention measures besides baseline screening for LTBI. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 56 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 10 | 18% |
| Researcher | 7 | 13% |
| Student > Postgraduate | 4 | 7% |
| Student > Doctoral Student | 3 | 5% |
| Other | 3 | 5% |
| Other | 9 | 16% |
| Unknown | 20 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 43% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
| Immunology and Microbiology | 2 | 4% |
| Nursing and Health Professions | 1 | 2% |
| Unspecified | 1 | 2% |
| Other | 2 | 4% |
| Unknown | 24 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 August 2018.
All research outputs
#18,647,094
of 23,100,534 outputs
Outputs from Clinical Rheumatology
#2,369
of 3,049 outputs
Outputs of similar age
#320,512
of 432,069 outputs
Outputs of similar age from Clinical Rheumatology
#31
of 55 outputs
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