Tumor Necrosis Factor-α Blocker Induced Tuberculosis

Kharbanda, P; Dagaonkar, Rucha S; Balakrishnan, C D; Udwadia, Zarir F

doi:10.3899/jrheum.100058

Cited by 7 publications

(4 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Notably, reactivation of latent mycobacterium tuberculosis or development of new tuberculosis infection have been reported with infliximab use. 38 Screening for tuberculosis prior to treatment initiation is recommended, particularly in endemic areas. Antituberculosis prophylaxis should be considered in suspected cases.…”

Section: Discussionmentioning

confidence: 99%

TNF-α Inhibitors for the Management of Intractable Corneal Melt: Report of Three Cases and Review of the Literature

Utine

Bırlık

Özizmirliler

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

View full text Add to dashboard Cite

To report three consecutive cases with noninfectious corneal melting, whose disease progression could only be halted with tumor necrosis-a (TNF-a) inhibitor infusion, with a review of the relevant literature. Materials and methods: Patients with toxic epidermal necrolysis, severe alkaline burn, and Sjögren syndrome had experienced severe corneal melting following penetrating keratoplasty, Boston type 1 keratoprosthesis implantation or spontaneously, respectively. Topical autologous serum eye-drops, medroxyprogesterone, and acetylcysteine formulations; frequent nonpreserved lubrication; systemic tetracyclines and vitamin-C supplements; topical and systemic steroids and steroid-sparing agents; surgical approaches including amniotic membrane transplantation, tectonic graft surgery; and tarsorraphy failed to alter the disease courses. Results: Upon consultation with the rheumatology clinic, TNF-a inhibitor infliximab (Remicade; Centocor Ortho Biotech Inc, Horsham, PA) 5 mg/kg infusion was planned for each patient. After 0-, 2-, and 6-week doses, monthly infusion at the same dose was maintained for 12 months because of severe and intractable course of their diseases. Each case showed dramatic improvements in corneal melts; and sterile vitritis in the eye with Boston keratoprosthesis responded, as well. Conclusions: Inhibiting TNF-a-mediated expression of matrix metalloproteinases responsible for collagen breakdown should be considered in refractory cases, as a means of globe salvage.

show abstract

Section: Discussionmentioning

confidence: 99%

TNF-α Inhibitors for the Management of Intractable Corneal Melt: Report of Three Cases and Review of the Literature

Utine

Bırlık

Özizmirliler

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

View full text Add to dashboard Cite

show abstract

“…[5] показали, что лечение ИНФ у больных РА ассоциировано со значительно большим риском возникновения серьезных инфекционных НР по сравнению с этанерцептом (ЭТЦ) [скорректированное О р и г и н а л ь н ы е и с с л е д о в а н и я Туберкулез. Туберкулез привлекает особое внимание среди инфекционных НР, тем более что на экспериментальных моделях показана защитная роль ФНОα по отношению к этой инфекции [7]. Риск развития туберкулеза у больных РА при лечении антагонистами ФНОα по сравнению с пациентами, которые их не получают, составляет 4,35-8,5 [8].…”

Section: Discussionunclassified

Infliximab tolerance in patients with rheumatoid arthritis in real clinical practice

Аронова¹,

Lukina²,

Сигидин³

2020

Naučno-praktičeskaâ revmatologiâ

View full text Add to dashboard Cite

Широкий спектр генно-инженерных биологических препаратов, введенных в клиническую ревматологию за последние годы, обусловливает особый интерес к их переносимости. В статье представлены собственные данные авторов, а также обзор зарубежной литературы, посвященной данному вопросу. Цель исследования-проанализировать переносимость инфликсимаба (ИНФ) у больных ревматоидным артритом (РА) в реальной клинической практике. Материал и методы. В анализ было включено 135 больных РА, получавших ИНФ в комбинации с базисными противовоспалительными препаратами или в виде монотерапии. Результаты и обсуждение. Общая переносимость ИНФ была удовлетворительной. Неблагоприятные реакции (НР) отмечались в 28,1% случаев, в том числе у 19 (14,1%) пациентов-серьезные НР, потребовавшие отмены препарата. Заключение. Наилучшая переносимость отмечалась при использовании комбинации ИНФ и метотрексата. Авторы обращают внимание на необходимость врачебного осмотра перед каждым введением препарата. Ключевые слова: биологическая терапия; генно-инженерные биологические препараты; инфликсимаб; ингибиторы фактора некроза опухоли α; неблагоприятные реакции; ревматоидный артрит.

show abstract

“…Good response to therapy, but for neurologic sequelae. Adalimumab stopped 4 weeks earlier, suggesting immune reconstitution inflammatory syndrome 7 [ 11 ] Polyarticular JIA Infliximab (previous MTX) 13y / male 3 m TB pleuritis (cultures negative) with good response to anti-TB therapy 8 [ 12 ] Ulcerative colitis Infliximab (previous CT and azathioprine) 17y / male 8 m Miliary TB; the patient developed isoniazid-related hepatitis, but showed good response later on to an isoniazid-free regimen 9 [ 12 ] Crohn’s disease Infliximab 13y / female 2y Disseminated TB disease with good response to 9-month standard therapy Nontuberculous mycobacterial disease 10 [ 13 ] Crohn’s disease Infliximab → adalimumab (previous CT) 12y / female 9 m Generalized lymphadenopathies due to culture-proven Mycobacterium avium complex infection; good response to ethambutol, clarithromycin and rifampin 11 [ 14 ] Mother’s Crohn disease Infliximab during gestation 3 m / male 36wk in utero Bottle-fed. BCG vaccination at 3 m of age; disseminated BCGitis leading to death 6 weeks later BCG bacillus Calmette-Guérin, CT corticosteroids, MTB Mycobacterium tuberculosis , MTX methotrexate, NR not reported, PCR polymerase chain reaction, Pt patient, Ref reference, SAPHO synovitis acne pustulosis hyperostosis and osteitis …”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in pediatric patients treated with anti-TNFα drugs: a cohort study

et al. 2015

View full text Add to dashboard Cite

BackgroundAdult patients receiving anti-TNFα drugs are at increased risk of tuberculosis (TB), but studies in pediatric populations are limited, and the best strategy for latent tuberculosis infection (LTBI) screening in this population remains controversial. We describe the prevalence of LTBI prior to anti-TNFα therapy and the long-term follow-up after biological treatment initiation in a cohort of children and adolescents.MethodsCohort observational study in children and adolescents receiving anti-TNFα agents in a tertiary-care pediatric hospital. LTBI was ruled out prior to the implementation of anti-TNFα drugs by tuberculin skin test (TST), and, from March 2012 on, QuantiFERON Gold-In Tube® test (QTF-G). During anti-TNFα treatment, patients were evaluated every 6 months for TB with history and physical examination. TST/QTF-G were not repeated unless signs or symptoms consistent with TB arose or there was proven TB contact.ResultsThe final cohort consisted of 221 patients (56.1 % female; 261 treatments), of whom 51.7 %/30.0 %/17.3 % were treated with etanercept/adalimumab/infliximab, respectively, for a variety of rheumatic diseases (75.6 %), inflammatory bowel disease (20.8 %), and inflammatory eye diseases (3.6 %). The median (IQR) age at diagnosis of the primary condition was 6.8 years (2.7–11.0) and the duration of the disease before implementing the anti-TNFα agent was 1.8 years (0.6–4.2). LTBI was diagnosed in 3 adolescent girls (prevalence rate: 1.4 %; 95 % CI: 0.4–4.2) affected with juvenile idiopathic arthritis: TST tested positive in only 1, while QTF-G was positive in all cases (including 2 patients already on etanercept). They all received antiTB chemoprophylaxis and were later (re)treated with etanercept for 24–29 months, without incidences. No incident cases of TB disease were observed during the follow-up period under anti-TNFα treatment of 641 patients-year, with a median (IQR) time per patient of 2.3 years (1.4–4.3).ConclusionsIn our study, the prevalence of LTBI (1.4 %) was similar to that reported in population screening studies in Spain; no incident cases of TB disease were observed. In low-burden TB settings, initial screening for TB in children prior to anti-TNFα treatment should include both TST and an IGRA test, but systematic repetition of LTBI immunodiagnostic tests seems unnecessary in the absence of symptoms or known TB contact.

show abstract

Tumor Necrosis Factor-α Blocker Induced Tuberculosis

Cited by 7 publications

References 5 publications

TNF-α Inhibitors for the Management of Intractable Corneal Melt: Report of Three Cases and Review of the Literature

TNF-α Inhibitors for the Management of Intractable Corneal Melt: Report of Three Cases and Review of the Literature

Infliximab tolerance in patients with rheumatoid arthritis in real clinical practice

Tuberculosis in pediatric patients treated with anti-TNFα drugs: a cohort study

Contact Info

Product

Resources

About