Mycobacterial diseases and antitumour necrosis factor therapy in USA

Winthrop, K.L.; Baxter, Roger; Liu, L; Varley, C.D.; Curtis, J. Randall; Baddley, J W; McFarland, Bentson H.; Austin, Donald; Radcliffe, Le Ann; Suhler, EB; Choi, Dongseok; Rosenbaum, J. T.; Herrinton, LJ

doi:10.1136/annrheumdis-2011-200690

Cited by 252 publications

(192 citation statements)

References 27 publications

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“…This may be explained by recent epidemiological studies [23,26] showing that NTM lung disease is most likely to develop in middle/old aged patients and in immunocompetent subjects. WINTHROP et al [27] revealed that NTM disease was associated rheumatoid arthritis among patients treated with a TNF-a antagonist. Among the six patients with NTM lung disease that developed during anti-TNF-a therapy, one had ulcerative colitis and five had rheumatoid arthritis; all six patients were middle-to-old age (age range 42-72 years).…”

Section: Discussionmentioning

confidence: 99%

Mycobacterial diseases developed during anti-tumour necrosis factor-α therapy

Yoo

Kang

et al. 2014

Eur Respir J

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Nontuberculous mycobacterial (NTM) disease and tuberculosis (TB) develop during antitumour necrosis factor (TNF)-a therapy. We compared clinical characteristics and outcomes between the two diseases.A total of 1165 patients were screened for TB and treated with TNF-a antagonists from July 2004 to July 2013 for the following conditions: inflammatory bowel disease (n5422), rheumatoid arthritis (n5320), and ankylosing spondylitis (n5389).TB and NTM disease were diagnosed at baseline screening in four and three patients, respectively, and developed during anti-TNF-a therapy in 19 and six patients, respectively. The incidence rate of TB and NTM disease was 747.7 per 100 000 and 238.2 per 100 000 person-years, respectively. Patients with NTM disease were older, with a greater proportion of females. All cases of NTM disease involved the lung, with rheumatoid arthritis (83.3%) being the most frequent underlying disease. The most common radiological feature was consolidation in NTM disease, and honeycombing was present in two rheumatoid arthritis patients with NTM disease. The most common pathogen was Mycobacterium intracellulare (n53) followed by Mycobacterium avium (n52). Both the NTM and TB group showed favourable outcomes.The clinical characteristics differed between NTM disease and TB that developed on anti-TNF-a agents, but clinical outcomes were favourable in both diseases. @ERSpublications Clinical characteristics differ between nontuberculous mycobacterial disease and TB that develop on anti-TNF-a agents

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Section: Discussionmentioning

confidence: 99%

Mycobacterial diseases developed during anti-tumour necrosis factor-α therapy

Yoo

Kang

et al. 2014

Eur Respir J

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“…Les bacilles qui ne sont pas éliminés par ces premières défenses se multiplient à l'intérieur des cellules dendritiques. Ils sont conduits aux ganglions régionaux où leurs antigènes sont présentés aux lymphocytes CD 4 + et CD 8 + qui vont être activés. C'est la deuxième étape dite adaptative.…”

Section: Histoire Naturelle De La Tuberculoseunclassified

“…Il était encore 2 à 4 fois plus important sous anti-TNFα. Au cours de la maladie de Crohn, le risque semble similaire même si l'incidence de TB chez les malades sans anti-TNFα n'a pas été étudiée [6][7][8].…”

Section: Les Agents Anti-tnfαunclassified

“…En revanche, l'association à d'autres immunosuppresseurs ne semblait pas être accompagnée de sur-risque, d'après une méta-analyse colligeant 5 études et totalisant 1 026 cas de maladie de Crohn [7]. Les autres facteurs de risque étaient l'âge, le diabète, l'insuffisance rénale [8] et surtout l'appartenance à une zone d'endémie et le type d'anti-TNFα utilisé. En effet, au Brésil par exemple, où l'incidence de TB dans la population générale est élevée (58/100 000 h), Nobre et al [9] • Un interrogatoire détaillé à la recherche : d'une vaccination par le BCG (Bacille de Calmette et Guérin) et le résultat des IDR (intra-dermo réaction) anciennes à la tuberculine, la notion de contage (antécédents familiaux, y compris dans l'enfance), la notion d'exposition (origine ou séjours prolongés dans des pays de forte endémie), antécédents personnels et familiaux de TB ou de traitements anti-tuberculeux (médicaments, dose et durée) ;…”

Section: Facteurs De Risqueunclassified

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Anti-TNFα et tuberculose

Bdioui¹

2013

Hegel

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RésuméLes anti-TNFα sont très efficaces dans le traitement des maladies inflammatoires chroniques rhumatismales et intestinales mais exposent à un risque élevé d'infections opportunistes, en particulier la tuberculose. Ce risque est multiplié par 2 à 10 chez les patients sous anti-TNFα par rapport à la population générale et par 2 à 4 par rapport aux malades sans anti-TNFα. Il s'agit le plus souvent de tuberculoses extrapulmonaires et de formes disséminées. Ces tuberculoses surviennent au cours de la première année de traitement et correspondent dans la majorité des cas à une réactivation de tuberculose latente ; d'où la mise en place de recommandations de dépistage et de prévention. Outre l'anamnèse, l'examen physique et la radiographie du thorax, la recherche d'une tuberculose latente repose aussi sur l'intradermoréaction à la tuberculine (IDR). Mais celle-ci présente certaines limites surtout chez ces malades immunodéprimés (faux négatifs) ou vaccinés par le BCG (faux positifs). Les tests de relargage de l'interféron-γ : IGRA (Interferon-Gamma Release Assays) semblent être plus sensibles et plus spécifiques et devraient être utilisés dans cette indication. La prophylaxie repose sur l'isoniaside seul pendant 9 mois ou l'association isoniazide-rifampicine pendant 3 mois). Elle doit être débutée au moins 3 semaines avant la première cure d'anti-TNFα. Ces stratégies se sont révélées efficaces en diminuant nettement le nombre de tuberculoses sous anti-TNFα en les ramenant aux taux avant anti-TNFα. Mots-clésAnti-TNFα ; Tuberculose ; Dépistage ; Prévention Abstract Anti-TNFα is a very effective treatment of the rheumatic and intestinal chronic inflammatory diseases but exposes to a high risk of opportunist infections, in particular tuberculosis. This risk increases twofold to tenfold when compared to the general population and by 2 to 4 when compared to the same patients without anti-TNFα. Non-pulmonary and disseminated tuberculosis are the most frequent forms with anti-TNFα. Tuberculosis arises during the first year of treatment and corresponds in most cases to a reactivation of latent tuberculosis; hence the implantation of recommendations of screening and prevention. Besides anamnesis, physical examination and chest X rays, screening for latent tuberculosis also relies on the tuberculin skin test (TST). But this presents limitations especially in immunosuppressed patients (false negative) or in BCG-vaccinated patients (false-positive

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“…Especially in female patients, D6S0009i MICA polymorphism (MICA-TM), and particularly its A6 allele, has been found in the above study has conferring genetic susceptibility to MAC. Also, since TNF locus, located in class III MHC region, is an important multifunctional proinflammatory agent, some therapies, especially in autoimmune diseases such as rheumatoid arthritis, uses TNF inhibitors which have been associated to an increased risk for MAC and other non-tuberculosis mycobacteriosis, besides TB mentioned above [105] . Despite with inconclusive results, other studies suggest that specific HLA alleles could be associated with the development of pulmonary MAC infection.…”

Section: Pulmonary Mac Infectionmentioning

confidence: 99%

HLA Loci and Respiratory Infectious Diseases

Spínola

2016

Journal of Respiratory Research

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The HLA system harbour a wide set of genes that plays an important role in the regulation and action of the immune system against invading pathogens, making them natural candidates for research on the genetic susceptibility for respiratory infections. Thus, along past decades, this topic has been subject to intense research and, consequently, several alleles of those loci have been implicated in the ability, more or less effective, to tackle and control invading pathogens in the respiratory system. Current editorial introduce, revise, summarize and comment the major advances in the role of HLA genes for the development of, and protection against, respiratory infectious disease. A general picture is drawn and new challenges on the field are relocated, especially those that might enlighten respiratory diseases aetiology and, thus, contribute in advances for diagnosis and treatment.

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Mycobacterial diseases and antitumour necrosis factor therapy in USA

Abstract: Among anti-TNF users in USA, mycobacterial disease rates are elevated, and NTM is associated with RA.

Cited by 252 publications

References 27 publications

Mycobacterial diseases developed during anti-tumour necrosis factor-α therapy

Mycobacterial diseases developed during anti-tumour necrosis factor-α therapy

Anti-TNFα et tuberculose

HLA Loci and Respiratory Infectious Diseases

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