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Clinical Rheumatology

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01-05-2020 | Tuberculosis | Original Article

Incidence of tuberculosis in patients receiving anti-TNF therapy for rheumatic diseases: a systematic review

Authors: Natália Sarzi Sartori, Nicole Pamplona Bueno de Andrade, Rafael Mendonça da Silva Chakr

Published in: Clinical Rheumatology | Issue 5/2020

Abstract

Introduction

The TNF inhibitors were the first immunobiologicals used to treat rheumatic diseases, but their use is associated with an increased risk of tuberculosis. The primary objective is to estimate the incidence of tuberculosis in patients with rheumatic diseases exposed to anti-TNF therapy. The secondary objectives are to evaluate the incidence of tuberculosis by region and subgroups of diseases, to review the presentation of tuberculosis in these patients, and to assess the time elapsed between onset of anti-TNF therapy and development of active granulomatous disease.

Methods

A systematic review of the literature was conducted in MEDLINE, the Cochrane Library, and LILACS. The primary endpoint was described as incidence and secondary outcomes, through subgroup analyses and comparisons of means.

Results

We included 52 observational studies. Among the exposed patients, 947 cases of tuberculosis were documented (62.2% pulmonary), with a cumulative incidence of 9.62 cases per 1000 patients exposed. TB incidence across different continents was distributed as follows: South America, 11.75 cases/1000 patients exposed; North America, 4.34 cases/1000 patients exposed; Europe, 6.28 cases/1000 patients exposed; and Asia, 13.47 cases/1000 patients exposed. There were no significant differences in TB incidence among the described diseases. The mean time elapsed from start of anti-TNF therapy until the endpoint was 18.05 months.

Conclusion

The incidence of TB in patients with rheumatic diseases exposed TNF inhibitor considering all countries was 9.62 cases per 1000 patients exposed. TB incidence was higher in South America and Asia compared with North America and Europe. Most cases occurred in the first XX months of use, and the pulmonary form predominated.

Key Points

• Higher incidence of tuberculosis in patients exposed to anti-TNF compared with the general population.

• Higher incidence of TB in countries of South America and Asia compared with North America and Europe.

Available only for authorised users

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Title: Incidence of tuberculosis in patients receiving anti-TNF therapy for rheumatic diseases: a systematic review
Authors: Natália Sarzi Sartori
Nicole Pamplona Bueno de Andrade
Rafael Mendonça da Silva Chakr
Publication date: 01-05-2020
Publisher: Springer London
Keywords: Tuberculosis
TNF-Inhibitors
Tuberculosis
Published in: Clinical Rheumatology / Issue 5/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04866-x

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

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Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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Other articles of this Issue 5/2020

Elevated serum interleukin-34 level in juvenile systemic lupus erythematosus and disease activity

At the crossroads of gout and psoriatic arthritis: “psout”

The clinical value of interleukins-8, -10, and -17 in idiopathic granulomatous mastitis

Real-world experience of secukinumab treatment for ankylosing spondylitis at the Royal National Hospital for Rheumatic Diseases, Bath

Diagnostic value of ultrasound versus dual-energy computed tomography in patients with different stages of acute gouty arthritis

Safety and efficacy of tocilizumab as monotherapy or in combination with methotrexate in Tunisian patients with active rheumatoid arthritis and inadequate response to disease-modifying anti-rheumatic drugs in conditions close to clinical practice

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage