Knee tuberculosis under rituximab therapy for rheumatoid arthritis

Ottaviani, Sébastien; Tiendrébéogo, Joelle; Choudat, Laurence; Gill, Ghislaine; Palazzo, Élisabeth; Meyer, Olivier; Dieudé, Philippe

doi:10.1016/j.jbspin.2012.10.018

Cited by 14 publications

(12 citation statements)

References 8 publications

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“…Another case of TB knee arthritis in a 42-year-old woman patient receiving RTX has been published [141]. This patient was not screened for LTBI and she was living in Cambodia, a country at high TB risk.…”

Section: Resultsmentioning

confidence: 99%

Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics

Cantini

Nannini

Niccoli

et al. 2017

Mediators of Inflammation

113

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Tuberculosis (TB) still represents an important issue for public health in underdeveloped countries, but the use of antitumor necrosis factor agents (anti-TNF) for the treatment of inflammatory rheumatic disorders has reopened the problem also in countries with low TB incidence, due to the increased risk of TB reactivation in subjects with latent tuberculosis infection (LTBI). Over the last 5 years, several non-anti-TNF-targeted biologics have been licensed for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. We reviewed the epidemiology of TB, the role of different cytokines and of the immune system cells involved in the immune response against TB infection, the methods to detect LTBI, and the risk of TB reactivation in patients exposed to non-anti-TNF-targeted biologics. Given the limited role exerted by the cytokines different from TNF, as expected, data from controlled trials, national registries of biologics, and postmarketing surveillance show that the risk of TB reactivation in patients receiving non-anti-TNF-targeted biologics is negligible, hence raising the question whether the screening procedures for LTBI would be necessary.

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Section: Resultsmentioning

confidence: 99%

Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics

Cantini

Nannini

Niccoli

et al. 2017

Mediators of Inflammation

113

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“…On the other hand, the case reports and national registries indicate that TB infection is also possible using RTX. 8 , 16 – 18 Three cases of active TB were reported in a survey conducted by the Emerging Infections Network. 19 A 42-year-old woman with RA developed knee TB arthritis while receiving RTX.…”

Section: Discussionmentioning

confidence: 99%

<p>Tuberculosis Arthritis in the Wrist While Using Rituximab for Rheumatoid Arthritis Treatment</p>

Ulusoy

Cakan

Tuna

2020

OARRR

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Introduction Data from clinical trials indicate that there are no increased risk of tuberculosis (TB) infections in rheumatoid arthritis (RA) patients while using rituximab (RTX). Herein, we report a RA patient who developed TB arthritis while using RTX. Case Report A 49-year-old patient was treated with methotrexate and prednisolone along with RTX for two years. Later, she presented with increasing pain, swelling, redness and cutaneous fistulization in her left wrist for two months. The lesion on the wrist was debritted. Histopathologic evaluation revealed the presence of acid-fast bacilli. Polymerase chain reaction test and culture confirmed mycobacterium tuberculosis. RTX, methotrexate and prednisolone were withdrawn. The patient was treated with 12-month course of antituberculous treatment and responded well. The patient, who did not have pain or swelling in her other joints, was not given any treatment for RA after antituberculous treatment. Conclusion Clinicians should keep in mind that TB infections may be encountered while using RTX. Latent TB screening may be appropriate in patients using concomitant corticosteroid and living in TB endemic areas.

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“…35 60 Reports of tuberculosis reactivation with rituximab and abatacept are rare, and rituximab is considered safer. [61][62][63][64] A global review of tocilizumab clinical trials found only eight reported cases of reactivation of tuberculosis. 65 Recommendations (table 1) The ACR recommends screening for latent tuberculosis before starting treatment with any bDMARD.…”

Section: Tuberculosismentioning

confidence: 99%

How to use biologic agents in patients with rheumatoid arthritis who have comorbid disease

Richards

Dowell

Quinones

et al. 2015

BMJ

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Although biologic disease modifying anti-rheumatic drugs (bDMARDs) have improved the quality of life of patients with rheumatoid arthritis, side effects remain a problem, especially for patients with pre-existing comorbidities. Randomized controlled trials of such drugs in rheumatoid arthritis typically exclude patients with comorbidities and are of short duration, so they do not provide data on adverse events in these people. Other data sources such as national bDMARD registries are limited by the preselection of patients for both conventional synthetic chemical compound disease modifying anti-rheumatic drugs (csDMARDs) and bDMARDs, and although these databases document comorbidity, they rarely report its severity. This too limits definitive statements on the progression or resolution of pre-existing disease. Although bDMARDs may not be contraindicated in patients with rheumatoid arthritis and certain comorbid diseases, additional assessments or precautions are recommended. This review summarizes current data on the use of bDMARDs in people with rheumatoid arthritis and common comorbid diseases. It provides an evidence base for doctors and their patients when discussing and selecting the appropriate bDMARDs.

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Knee tuberculosis under rituximab therapy for rheumatoid arthritis

Cited by 14 publications

References 8 publications

Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics

Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics

<p>Tuberculosis Arthritis in the Wrist While Using Rituximab for Rheumatoid Arthritis Treatment</p>

How to use biologic agents in patients with rheumatoid arthritis who have comorbid disease

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