Re: RESEARCH - Risk of TB in patients treated with TNF antagonists due to incomplete prevention of reactivation of latent infection

[Guest guest]

Can someone tell me if having a TB test would be bad for someone taking

plaquenil? Thank you for your comments.

Cheryl

[ ] RESEARCH - Risk of TB in patients treated with TNF

antagonists due to incomplete prevention of reactivation of latent infection

Arthritis Rheum. 2007 Jun 15;57(5):756-61.

Risk of tuberculosis in patients treated with tumor necrosis factor

antagonists due to incomplete prevention of reactivation of latent

infection.

Gómez-Reino JJ, Carmona L, Angel Descalzo M; Biobadaser Group.

Hospital Clínico Universitario, University of Santiago de Compostela

School of Medicine, Santiago, Spain.

OBJECTIVE: To evaluate the causes of new cases of active tuberculosis

(ATB) in patients treated with tumor necrosis factor (TNF) antagonists

included in the national registry BIOBADASER (Base de Datos de

Productos Biológicos de la Sociedad Española de Reumatología) after

the dissemination of recommendations to prevent reactivation of latent

tuberculosis infection (LTBI). METHODS: Incidence rate of ATB per

100,000 patient-years and 95% confidence intervals (95% CIs) were

calculated in patients entering BIOBADASER after March 2002 and were

stratified by compliance with recommendations (complete or

incomplete). ATB rates in BIOBADASER were compared with the background

rate and the rate in the rheumatoid arthritis cohort EMECAR (Estudio

de la Morbilidad y Expresión Clínica de la Artritis Reumatoide) not

treated with TNF antagonists. In addition, rates of ATB among patients

treated with adalimumab, etanercept, and infliximab were estimated and

compared only for treatments started after September 2003, when all 3

drugs became fully available. RESULTS: Following March 2002, a total

of 5,198 patients treated with a TNF antagonist were registered in

BIOBADASER. Fifteen ATB cases were noted (rate 172 per 100,000

patient-years, 95% CI 103-285). Recommendations were fully followed in

2,655 treatments. The probability of developing ATB was 7 times higher

when recommendations were not followed (incidence rate ratio 7.09, 95%

CI 1.60-64.69). Two-step tuberculosis skin test for LTBI was the major

failure in complying with recommendations.

CONCLUSION: New cases of ATB still occur in patients treated with all

available TNF antagonists due to lack of compliance with

recommendations to prevent reactivation of LTBI. Continuous evaluation

of recommendations is required to improve clinical practice.

PMID: 17530674

http://www.ncbi.nlm.nih.gov/pubmed/17530674

--

Not an MD

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[Guest guest]

Cheryl, I wouldn't think so, did your dr say not to do it?

[ ] RESEARCH - Risk of TB in patients treated with TNF

antagonists due to incomplete prevention of reactivation of latent infection

Arthritis Rheum. 2007 Jun 15;57(5):756- 61.

Risk of tuberculosis in patients treated with tumor necrosis factor

antagonists due to incomplete prevention of reactivation of latent

infection.

Gómez-Reino JJ, Carmona L, Angel Descalzo M; Biobadaser Group.

Hospital Clínico Universitario, University of Santiago de Compostela

School of Medicine, Santiago, Spain.

OBJECTIVE: To evaluate the causes of new cases of active tuberculosis

(ATB) in patients treated with tumor necrosis factor (TNF) antagonists

included in the national registry BIOBADASER (Base de Datos de

Productos Biológicos de la Sociedad Española de Reumatología) after

the dissemination of recommendations to prevent reactivation of latent

tuberculosis infection (LTBI). METHODS: Incidence rate of ATB per

100,000 patient-years and 95% confidence intervals (95% CIs) were

calculated in patients entering BIOBADASER after March 2002 and were

stratified by compliance with recommendations (complete or

incomplete). ATB rates in BIOBADASER were compared with the background

rate and the rate in the rheumatoid arthritis cohort EMECAR (Estudio

de la Morbilidad y Expresión Clínica de la Artritis Reumatoide) not

treated with TNF antagonists. In addition, rates of ATB among patients

treated with adalimumab, etanercept, and infliximab were estimated and

compared only for treatments started after September 2003, when all 3

drugs became fully available. RESULTS: Following March 2002, a total

of 5,198 patients treated with a TNF antagonist were registered in

BIOBADASER. Fifteen ATB cases were noted (rate 172 per 100,000

patient-years, 95% CI 103-285). Recommendations were fully followed in

2,655 treatments. The probability of developing ATB was 7 times higher

when recommendations were not followed (incidence rate ratio 7.09, 95%

CI 1.60-64.69). Two-step tuberculosis skin test for LTBI was the major

failure in complying with recommendations.

CONCLUSION: New cases of ATB still occur in patients treated with all

available TNF antagonists due to lack of compliance with

recommendations to prevent reactivation of LTBI. Continuous evaluation

of recommendations is required to improve clinical practice.

PMID: 17530674

http://www.ncbi. nlm.nih.gov/ pubmed/17530674

--

Not an MD

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