Reactivation of Tuberculosis in Three Cases of Psoriasis after Initiation of Anti-TNF Therapy

Shaikha, Samya Abu; Mansour, Khalid; Riad, Hassan

doi:10.1159/000337145

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…From another point of view, the study of Yang et al [ 41 ] highlights that TB is a major problem in endemic areas. Furthermore, clinical practice continues to provide details concerning the increasing numbers of patients with active TB, despite the screening methods for detecting LTBI [ 42 – 47 ].…”

Section: Discussionmentioning

confidence: 99%

Psoriasis, Anti-Tumor Necrosis Factor Therapy, and Tuberculosis: Report of Three Challenging Cases and Literature Review

Solovan

Chiticariu

2013

Infect Dis Ther

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IntroductionThe era of biologic therapies has provided new options for the treatment of chronic plaque psoriasis. However, safety concerns have led to intensive screening and monitoring of patients receiving anti-tumor necrosis factor alpha (anti-TNF-alpha) agents.MethodsThe authors describe the cases of three patients with moderate to severe psoriasis treated with anti-TNF agents, with challenging diagnostic and treatment aspects regarding tuberculosis (TB) infection, a serious adverse event associated with this type of treatment. The cases are discussed in the context of a comprehensive literature review describing the risk of TB associated with the use of TNF inhibitors. A critical review of the clinical trials that have tested the safety of these agents is also presented.ResultsOne patient, who tested negatively for latent TB infection (LTBI) during screening, developed active TB under adalimumab therapy. For two other patients the diagnosis and management of LTBI in relation to anti-TNF therapy represented a challenge. Although clinical trials involving the use of anti-TNF therapy for psoriasis haven’t demonstrated a high TB incidence, active TB is continuously reported in association with this treatment.ConclusionsFindings from clinical practice and the scientific literature indicate that anti-TNF therapies are associated with an increased risk of TB, and close monitoring of patients is needed.

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Section: Discussionmentioning

confidence: 99%

Psoriasis, Anti-Tumor Necrosis Factor Therapy, and Tuberculosis: Report of Three Challenging Cases and Literature Review

Solovan

Chiticariu

2013

Infect Dis Ther

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“…The protective role of TNFα is further highlighted in those patients with autoimmune and chronic diseases who are undergoing anti-TNFα neutralizing therapies including infliximab, adalimumab, and etanercept (43, 44). Though this therapy is successful at treating the autoimmune disease, a significant correlation between reactivation of latent TB in patients undergoing anti-TNFα therapy has been reported (45–52). Patients using infliximab and/or adalimumab have a higher incidence of TB reactivation in extra pulmonary sites compared to etanercept (50).…”

Section: Cytokinesmentioning

confidence: 99%

Cytokines and Chemokines inMycobacterium tuberculosisInfection

et al. 2016

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Chemokines and cytokines are critical for initiating and coordinating the organized and sequential recruitment and activation of cells into Mycobacterium tuberculosis -infected lungs. Correct mononuclear cellular recruitment and localization are essential to ensure control of bacterial growth without the development of diffuse and damaging granulocytic inflammation. An important block to our understanding of TB pathogenesis lies in dissecting the critical aspects of the cytokine/chemokine interplay in light of the conditional role these molecules play throughout infection and disease development. Much of the data highlighted in this review appears at first glance to be contradictory, but it is the balance between the cytokines and chemokines that is critical, and the “goldilocks” (not too much and not too little) phenomenon is paramount in any discussion of the role of these molecules in TB. Determination of how the key chemokines/cytokines and their receptors are balanced and how the loss of that balance can promote disease is vital to understanding TB pathogenesis and to identifying novel therapies for effective eradication of this disease.

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“…The protective role of TNFα is further highlighted in those patients with autoimmune and chronic diseases who are undergoing anti-TNFα-neutralizing therapies, including infliximab, adalimumab, and etanercept (43,44). Although this therapy is successful at treating the autoimmune disease, a significant correlation between reactivation of latent TB in patients undergoing anti-TNFα therapy has been reported (45)(46)(47)(48)(49)(50)(51)(52). Patients using infliximab and/or adalimumab have a higher incidence of TB reactivation in extrapulmonary sites compared with etanercept (50).…”

Section: Cytokines Tumor Necrosis Factor Alphamentioning

confidence: 99%

Cytokines and Chemokines inMycobacterium tuberculosisInfection

Domingo-Gonzalez

Prince

Cooper

et al. 2017

Tuberculosis and the Tubercle Bacillus

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Chemokines and cytokines are critical for initiating and coordinating the organized and sequential recruitment and activation of cells into Mycobacterium tuberculosis-infected lungs. Correct mononuclear cellular recruitment and localization are essential to ensure control of bacterial growth without the development of diffuse and damaging granulocytic inflammation. An important block to our understanding of TB pathogenesis lies in dissecting the critical aspects of the cytokine/chemokine interplay in light of the conditional role these molecules play throughout infection and disease development. Much of the data highlighted in this review appears at first glance to be contradictory, but it is the balance between the cytokines and chemokines that is critical, and the "goldilocks" (not too much and not too little) phenomenon is paramount in any discussion of the role of these molecules in TB. Determination of how the key chemokines/cytokines and their receptors are balanced and how the loss of that balance can promote disease is vital to understanding TB pathogenesis and to identifying novel therapies for effective eradication of this disease.

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Reactivation of Tuberculosis in Three Cases of Psoriasis after Initiation of Anti-TNF Therapy

Cited by 11 publications

References 10 publications

Psoriasis, Anti-Tumor Necrosis Factor Therapy, and Tuberculosis: Report of Three Challenging Cases and Literature Review

Psoriasis, Anti-Tumor Necrosis Factor Therapy, and Tuberculosis: Report of Three Challenging Cases and Literature Review

Cytokines and Chemokines inMycobacterium tuberculosisInfection

Cytokines and Chemokines inMycobacterium tuberculosisInfection

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