Association between traditional systemic antipsoriatic drugs and tuberculosis risk in patients with psoriasis with or without psoriatic arthritis: Results of a nationwide cohort study from Taiwan

Treatment of severe non-infectious uveitis in high-risk conditions (Part 2): systemic infections; management and safety issues

“…In spite of its singularity, this case seems to share certain characteristics with previously reported cases [146] in that, as the authors indicate, there is a need for monitoring these potential complications in patients treated with MTX [145]. Moreover, Chen et al reported the potential relationship between the use of these traditional IS agents for treatment of psoriasis (with or without associated arthritis) and developing of active TB [147]. This retrospective cohort study calculated an incidence rate of 102 cases per 100,000 population-year, which was slightly superior than that for the general population [148], with pulmonary disease being the most frequent clinical form (90.5%), followed far behind by bone or joint involvement (3%) [147].…”

“…This retrospective cohort study calculated an incidence rate of 102 cases per 100,000 population-year, which was slightly superior than that for the general population [148], with pulmonary disease being the most frequent clinical form (90.5%), followed far behind by bone or joint involvement (3%) [147]. In addition, the authors found a significant correlation between psoriasis severity and risk of active TB, but not with traditional IS agents (MTX, cyclosporine-A, AZA, mycofenolate mofetil) except in the case of systemic steroids [147]. Concern about this potential relationship is also reflected in the study by Bogas et al [149], although this review only found a case--control study in which a clear and significant relationship between the use of MTX and increased incidence of active TB was not established [150].…”

“…Moreover, Chen et al reported the potential relationship between the use of these traditional IS agents for treatment of psoriasis (with or without associated arthritis) and developing of active TB [147]. This retrospective cohort study calculated an incidence rate of 102 cases per 100,000 population-year, which was slightly superior than that for the general population [148], with pulmonary disease being the most frequent clinical form (90.5%), followed far behind by bone or joint involvement (3%) [147]. In addition, the authors found a significant correlation between psoriasis severity and risk of active TB, but not with traditional IS agents (MTX, cyclosporine-A, AZA, mycofenolate mofetil) except in the case of systemic steroids [147].…”

Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry

“…However, a recent nationwide cohort study (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) in Taiwan on a large sample population (n = 81 266) reported that traditional systemic antipsoriatic drugs including ciclosporin and methotrexate were not associated with TB development in patients with psoriasis with or without arthritis. 15 Accordingly, the European S3 guidelines on the systemic treatment of psoriasis vulgaris do not recommend screening for LTBI in patients candidate to acitretin, methotrexate, ciclosporin or phototherapy. 16 Conversely, the American guidelines of care for the management and treatment of psoriasis with traditional systemic agents recommend testing for LTBI with TST in patients candidate to either methotrexate or ciclosporin, 17 as reactivation of LTBI has been reported in transplant patients treated with ciclosporin.…”

Risk of incident active tuberculosis disease in patients treated with non-steroidal anti-inflammatory drugs: a population-based study

“…As far as we were aware of, there is only one small-scale observation study that investigates the direct relationship between use of NSAIDs and active TB onset, and two small-scale observation studies that we can infer the relationship between NSAIDs and active TB onset [12–14]. In 1984, the Bass group showed that in 38 latent TB patients, the chance of developing active TB is directly increased with the use of NSAIDs [13].…”