Tuberculosis Screening Before and During Treatment with Tumor Necrosis Factor Antagonists: Something Old, Something New

Hatemi, Gülen; Yazıcı, Hasan

doi:10.3899/jrheum.131218

Cited by 8 publications

(3 citation statements)

References 18 publications

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“…Reactivation of latent tuberculosis tends to occur earlier and primary active tuberculosis usually develops later in the course of therapy. 10 In the present report, both study patients were under adalimumab therapy for the previous 3 years before developing uveitis. Therefore, we assume that they had primary tuberculosis infection since the disease appeared after a long period of immunosuppression.…”

Section: Discussionmentioning

confidence: 62%

Presumed Tuberculous Multifocal Retinitis in Patients Under Treatment With Biologic Agents

Arantes

Lima

Bressanin³

et al. 2021

RETINAL Cases &Amp; Brief Reports

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Purpose: To report unique retinal fundus lesions and treatment outcomes of intraocular tuberculosis in patients under anti-tumor necrosis factor treatment.Methods: Retrospective review of two patients with laboratorial evidence of tuberculosis who had bilateral ocular signs and symptoms not attributable to other diseases. Multimodal imaging was analyzed at the time of presentation and after the treatment initiation. The study patients underwent standard treatment for tuberculosis.Results: Clinical and laboratory findings were consistent with the diagnosis of presumed tuberculosis. Color fundus photograph revealed the presence of multifocal yellowish retinal spots in the study eyes. On fluorescein angiography, the retinal lesions seen on color fundus photograph showed early hypofluorescence with progressive staining of its edges. Occlusive vasculitis with peripheral nonperfusion was also observed in both cases. Spectral domain optical coherence tomography demonstrated increased reflectivity and thickness on the topography of retinitis lesions. After specific antibiotic treatment for tuberculosis, there was complete disappearance of the retinal lesions in all study eyes. Conclusion:We report two unique cases of bilateral presumed intraocular tuberculosis presenting as multifocal retinitis in patients under biologic agent treatment. Antitumor necrosis factor agents may be related to unusual fundus manifestations of tuberculosis.

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Section: Discussionmentioning

confidence: 62%

Presumed Tuberculous Multifocal Retinitis in Patients Under Treatment With Biologic Agents

Arantes

Lima

Bressanin³

et al. 2021

RETINAL Cases &Amp; Brief Reports

View full text Add to dashboard Cite

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“…67 Regional guidelines should be followed regarding the use and interpretation of these tests. Patients with positive results (TST or IGRA) should have a chest radiograph to exclude active tuberculosis and, if negative, begin treatment for latent tuberculosis infection one month before the start of bDMARD therapy.…”

Section: Tuberculosismentioning

confidence: 99%

“…29 The value of serial tuberculosis screening thereafter, in the absence of known exposure or high risk, is unclear. 67 All TNF-α inhibitors have been associated with reactivation of tuberculosis, and rituximab is considered the safest.…”

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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Anti-Rheumatic Therapy and Comorbidity

Richards

Dowell

Quinones

2017

Comorbidity in Rheumatic Diseases

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Tuberculosis Screening Before and During Treatment with Tumor Necrosis Factor Antagonists: Something Old, Something New

Cited by 8 publications

References 18 publications

Presumed Tuberculous Multifocal Retinitis in Patients Under Treatment With Biologic Agents

Presumed Tuberculous Multifocal Retinitis in Patients Under Treatment With Biologic Agents

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

Anti-Rheumatic Therapy and Comorbidity

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