Risk of tuberculosis in patients with chronic immune-mediated inflammatory diseases treated with biologics and tofacitinib: a systematic review and meta-analysis of randomized controlled trials and long-term extension studies

Abstract

RCTs are not sensitive enough to assess the risk of reactivation of latent TB infection (LTBI). Disease, treatment and background TB rate are associated with different frequencies of active TB. The benefit/risk balance of preventing reactivation of LTBI in different backgrounds should be considered in clinical practice.

Safety and Efficacy of Biological Disease-Modifying Antirheumatic Drugs in Older Rheumatoid Arthritis Patients: Staying the Distance

“…This risk while receiving treatment, however, was inversely associated with control of disease activity but not with lipid changes, suggesting indeed that better control of inflammation may at least partially offset an eventual increased risk due to drug-associated dyslipidemia [88]. No TB cases were observed in RCTs in patients treated with tocilizumab [69].…”

“…The estimated rate in the senior patients is around 6.8% [40]. [66] With regards to tuberculosis (TB), the patients included in RCTs after a screening for latent infection, did not seem to have a higher incidence than the control groups or general population [69,70]. As for the elderly, no cases of TB were reported in the secondary analysis of etanercept trials [56,46].…”

“…Just like for anti-TNF agents, some data suggest that severe infections are more frequent in the elderly (19.5%) and very elderly (26.5%), compared to less than 5% in the young subjects [89] but these data were not confirmed in the German cohort. Only two cases of TB were reported in the all-exposure population treated with rituximab in the clinical trial program [69]. Low IgG levels induced by or associated with the treatment, although rare (4%), are associated with higher rates of severe infection [91].…”

Targeted Therapy and Infections in Rheumatic Diseases

“…На современном этапе развитие ТБ отмечено при лече-нии практически всеми ГИБП (в большей или меньшей сте-пени) [77]. Опасность развития ТБ на фоне таргетной тера-пии непосредственно связана с распространением данной инфекции в популяции.…”

Biological Therapy and Infection in Rheumatoid Arthritis Patients: Modern Aspects

“…На современном этапе развитие ТБ отмечено при лечении всеми ГИБП (в большей или меньшей степени) [56]. Опасность развития ТБ на фоне биологической тера-пии непосредственно связана с распространением дан-ной инфекции в популяции.…”