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Incidence of active mycobacterial infections in Brazilian patients with chronic inflammatory arthritis and negative evaluation for latent tuberculosis infection at baseline - A longitudinal analysis…

Overview of attention for article published in Memórias do Instituto Oswaldo Cruz, November 2015
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Title
Incidence of active mycobacterial infections in Brazilian patients with chronic inflammatory arthritis and negative evaluation for latent tuberculosis infection at baseline - A longitudinal analysis after using TNFa blockers
Published in
Memórias do Instituto Oswaldo Cruz, November 2015
DOI 10.1590/0074-02760150235
Pubmed ID
Authors

Carina Mori Frade Gomes, Maria Teresa Terreri, Maria Isabel de Moraes-Pinto, Cássia Barbosa, Natália Pereira Machado, Maria Roberta Melo, Marcelo Medeiros Pinheiro

Abstract

Several studies point to the increased risk of reactivation of latent tuberculosis infection (LTBI) in patients with chronic inflammatory arthritis (CIAs) after using tumour necrosis factor (TNF)a blockers. To study the incidence of active mycobacterial infections (aMI) in patients starting TNFa blockers, 262 patients were included in this study: 109 with rheumatoid arthritis (RA), 93 with ankylosing spondylitis (AS), 44 with juvenile idiopathic arthritis (JIA) and 16 with psoriatic arthritis (PsA). All patients had indication for anti-TNFatherapy. Epidemiologic and clinical data were evaluated and a simple X-ray and tuberculin skin test (TST) were performed. The control group included 215 healthy individuals. The follow-up was 48 months to identify cases of aMI. TST positivity was higher in patients with AS (37.6%) than in RA (12.8%), PsA (18.8%) and JIA (6.8%) (p < 0.001). In the control group, TST positivity was 32.7%. Nine (3.43%) patients were diagnosed with aMI. The overall incidence rate of aMI was 86.93/100,000 person-years [95% confidence interval (CI) 23.6-217.9] for patients and 35.79/100,000 person-years (95% CI 12.4-69.6) for control group (p < 0.001). All patients who developed aMI had no evidence of LTBI at the baseline evaluation. Patients with CIA starting TNFa blockers and no evidence of LTBI at baseline, particularly with nonreactive TST, may have higher risk of aMI.

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Mendeley readers

The data shown below were compiled from readership statistics for 77 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Canada 1 1%
Unknown 75 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 18%
Student > Ph. D. Student 12 16%
Student > Master 11 14%
Student > Postgraduate 9 12%
Student > Bachelor 8 10%
Other 11 14%
Unknown 12 16%
Readers by discipline Count As %
Medicine and Dentistry 32 42%
Pharmacology, Toxicology and Pharmaceutical Science 7 9%
Nursing and Health Professions 5 6%
Biochemistry, Genetics and Molecular Biology 3 4%
Psychology 3 4%
Other 10 13%
Unknown 17 22%