Preventing tuberculosis in children receiving anti-tnf treatment

被引:0
作者
Nuray Aktay Ayaz
Erkan Demirkaya
Yelda Bilginer
Uğur Özçelik
Nazan Çobanoğlu
Nural Kiper
Nesrin Besbas
Aysin Bakkaloğlu
Seza Özen
机构
[1] Acıbadem University,Medical Faculty, Pediatric Rheumatology Unit
[2] Hacettepe University,Medical Faculty, Pediatric Nehrology
[3] Hacettepe University,Rheumatology Unit
[4] Hacettepe University,Medical Faculty, Pediatric Pulmonology Unit
来源
Clinical Rheumatology | 2010年 / 29卷
关键词
Anti-TNF; Juvenile idiopathic arthritis; Tuberculosis;
D O I
暂无
中图分类号
学科分类号
摘要
Anti-tumor necrosis factor (TNF) treatment has been a breakthrough in the management of juvenile idiopathic arthritis (JIA). However, they are associated with a significant risk of tuberculosis. We evaluated JIA patients who received etanercept treatment from an eastern Mediterranean country with moderate tuberculosis frequency. JIA patients under anti-TNF treatment, etanercept, were enrolled to the study. Chest X-rays, Tuberculin Skin Test (TST), clinical histories, family screening, and physical examinations were reviewed retrospectively. If TST was above 10 mm in a patient with one Bacillus Calmette-Guerin, cultures and, if needed, thorax computerized tomography were obtained. These patients received 1-2 months of isoniazid (INH) treatment which was followed by an INH prophylaxis for a period of 9 months while etanercept treatment was started. All were re-evaluated within 3 months intervals. A total of 36 patients under etanercept treatment were enrolled to the study. Mean age of the patients was 14.00 years (range 4-22 years). Median duration of disease was 36.00 months (range 4-216 months). Median duration of etanercept therapy was 11.5 months (3-48 months) at final evaluation. Seven patients had an initial TST score above 10 mm. All received INH treatment as outlined above. They had normal examinations and X-rays during follow-up. With proper initial evaluation, anti-TNF treatment is safe even in countries where tuberculosis is moderately frequent. An initial 1-2 months of INH treatment followed by chemoprophylaxis for 9 months is suggested for children with a TST of >10 mm.
引用
收藏
页码:389 / 392
页数:3
相关论文
共 50 条
  • [21] Tuberculosis in pediatric patients treated with anti-TNFα drugs: a cohort study
    Joan Calzada-Hernández
    Jordi Anton-López
    Rosa Bou-Torrent
    Estíbaliz Iglesias-Jiménez
    Sílvia Ricart-Campos
    Javier Martín de Carpi
    Vicenç Torrente-Segarra
    Judith Sánchez-Manubens
    Clara Giménez-Roca
    Librada Rozas-Quesada
    Maria Teresa Juncosa-Morros
    Clàudia Fortuny
    Antoni Noguera-Julian
    Pediatric Rheumatology, 13
  • [22] Safety of anti-TNFα therapy in children with juvenile idiopathic arthritis
    Dekker, L
    Armbrust, W
    Rademaker, CMA
    Prakken, B
    Kuis, W
    Wulffraat, NM
    CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 2004, 22 (02) : 252 - 258
  • [23] HLA B subtype analysis in patients developing tuberculosis during anti-TNF treatment
    Fatih Albayrak
    Gökhan Keser
    Serdar Oztuzcu
    Belkıs Nihan Coşkun
    Yavuz Pehlivan
    Tuba Demirci Yıldırım
    Gökçe Kenar Artın
    Gözde Çetin Yıldırım
    Bünyamin Kısacık
    Scientific Reports, 15 (1)
  • [24] Risk of developing tuberculosis under anti-TNF treatment despite latent infection screening
    Jauregui-Amezaga, Aranzazu
    Turon, Fanny
    Ordas, Ingrid
    Gallego, Marta
    Feu, Faust
    Ricart, Elena
    Panes, Julian
    JOURNAL OF CROHNS & COLITIS, 2013, 7 (03) : 208 - 212
  • [25] Incidence of tuberculosis among anti-TNF users in patients with previous history of tuberculosis
    Jo, Kyung-Wook
    Hong, YoonKi
    Jung, Young Ju
    Lee, Sang-Do
    Kim, Woo Sung
    Kim, Dong Soon
    Shim, Tae Sun
    EUROPEAN RESPIRATORY JOURNAL, 2013, 42
  • [26] Screening for tuberculosis in patients candidates for anti-TNF terapy in IBD
    Atanassova, Antoniayordanova
    Kotzev, Iskren
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2013, 28 : 141 - 141
  • [27] Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country
    Brunelli, Juliana Barbosa
    Bonfiglioli, Karina Rossi
    Silva, Clovis A.
    Kozu, Katia Tomie
    Goldenstein-Schainberg, Claudia
    Bonfa, Eloisa
    Aikawa, Nadia Emi
    REVISTA BRASILEIRA DE REUMATOLOGIA, 2017, 57 (05) : 392 - 396
  • [28] Safety of resuming biologic DMARDs in patients who develop tuberculosis after anti-TNF treatment
    Cho, Soo-Kyung
    Kim, Dam
    Won, Soyoung
    Han, Minkyung
    Lee, Jiyoung
    Jang, Eun Jin
    Kim, Tae-Hyung
    Bae, Sang-Cheol
    Sung, Yoon-Kyoung
    SEMINARS IN ARTHRITIS AND RHEUMATISM, 2017, 47 (01) : 102 - 107
  • [29] Anti-TNF therapy
    Thalayasingam, Nishanthi
    Isaacs, John D.
    BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY, 2011, 25 (04): : 549 - 567
  • [30] Tuberculosis, anti-TNF agents and other immunosuppressants: evolution of preventitive strategies
    Liote, H.
    REVUE DES MALADIES RESPIRATOIRES, 2008, 25 (10) : 1237 - 1249