Risk of tuberculosis arthritis drug review

Treatment with anti-tumor necrosis factor (TNF) is considered a risk factor for tuberculosis (TB) in patients dependent on immuno-inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, the Psoriatic arthritis and psoriasis. Most cases of TB as a result of reactivation of latent tuberculosis infection, health authorities around the world and recommended for latent tuberculosis and treatment of patients before the start of anti-TNF-treatment. A new study of TB cases in conjunction with anti-TNF therapy and found that the risk of TB among patients, anti-TNF-monoclonal antibody therapy (infliximab or adalimumab) and for the beneficiaries soluble receptor-TNF therapy (etanercept). The study appears in the July edition of arthritis and rheumatism.

Conducted by Mariette Xavier University Paris-Sud, researchers, a national registry in France to collect all cases of tuberculosis during a period of three years in patients with anti-TNF therapy for any reason. The scientific data on 69 cases of tuberculosis, evaluation of risk factors for tuberculosis before anti-TNF-early anti-TNF treatment and treatment history.

The results showed that the risk of TB-patients, anti-TNF therapy compared to the French population is different depending on the anti-TNF-agent uses; beneficiaries monoclonal anti-TNF-treatment had a higher risk sTNFR of therapy. The risk of TB is highest during the first year of anti-TNF-treatment for the reactivation of latent tuberculosis. None of the patients on adequate prophylaxis for tuberculosis, which, in France, in most cases, the combination of INH and rifampicione for 3 months. Two thirds of cases of TB were observed in patients with skin test negative.

The authors stress that in other countries, records, to ensure the safety of anti-TNF-agent, but TB prices were so low that it was difficult to detect a difference in risk between the different types of anti - TNF -agents, the latter study, however, this difference. This study examined the cases of TB in the general population and french researchers were able, in many other cases. In addition, the registry, to ensure patient safety, anti-TNF treatment for each indication.

The mechanism by which anti-TNF reactivation of latent TB is not fully understood, but the authors suggest that differences in the effect of these two types of anti-TNF agents-in-aid T (cells that play an important role to optimize the capacity of the immune system) and regulatory T cells (suppression of activation of the immune system) as part of the explanation for differences in risk of TB observed. The authors conclude that differences with the two types of anti-TNF-treatment may also explain better efficacy of monoclonal antibody therapy of certain diseases such as Crohn's disease, sarcoidosis and uveitis.