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Clinical Rheumatology

Erschienen in:

01.05.2020 | Original Article

Incidence of tuberculosis in patients receiving anti-TNF therapy for rheumatic diseases: a systematic review

verfasst von: Natália Sarzi Sartori, Nicole Pamplona Bueno de Andrade, Rafael Mendonça da Silva Chakr

Erschienen in: Clinical Rheumatology | Ausgabe 5/2020

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Abstract

Introduction

The TNF inhibitors were the first immunobiologicals used to treat rheumatic diseases, but their use is associated with an increased risk of tuberculosis. The primary objective is to estimate the incidence of tuberculosis in patients with rheumatic diseases exposed to anti-TNF therapy. The secondary objectives are to evaluate the incidence of tuberculosis by region and subgroups of diseases, to review the presentation of tuberculosis in these patients, and to assess the time elapsed between onset of anti-TNF therapy and development of active granulomatous disease.

Methods

A systematic review of the literature was conducted in MEDLINE, the Cochrane Library, and LILACS. The primary endpoint was described as incidence and secondary outcomes, through subgroup analyses and comparisons of means.

Results

We included 52 observational studies. Among the exposed patients, 947 cases of tuberculosis were documented (62.2% pulmonary), with a cumulative incidence of 9.62 cases per 1000 patients exposed. TB incidence across different continents was distributed as follows: South America, 11.75 cases/1000 patients exposed; North America, 4.34 cases/1000 patients exposed; Europe, 6.28 cases/1000 patients exposed; and Asia, 13.47 cases/1000 patients exposed. There were no significant differences in TB incidence among the described diseases. The mean time elapsed from start of anti-TNF therapy until the endpoint was 18.05 months.

Conclusion

The incidence of TB in patients with rheumatic diseases exposed TNF inhibitor considering all countries was 9.62 cases per 1000 patients exposed. TB incidence was higher in South America and Asia compared with North America and Europe. Most cases occurred in the first XX months of use, and the pulmonary form predominated.

Key Points

• Higher incidence of tuberculosis in patients exposed to anti-TNF compared with the general population.

• Higher incidence of TB in countries of South America and Asia compared with North America and Europe.

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Titel: Incidence of tuberculosis in patients receiving anti-TNF therapy for rheumatic diseases: a systematic review
verfasst von: Natália Sarzi Sartori
Nicole Pamplona Bueno de Andrade
Rafael Mendonça da Silva Chakr
Publikationsdatum: 01.05.2020
Verlag: Springer London
Erschienen in: Clinical Rheumatology / Ausgabe 5/2020
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04866-x

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Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

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