Korean J Intern Med.  2013 Mar;28(2):174-179. 10.3904/kjim.2013.28.2.174.

Clinical characteristics and treatment responses of patients who developed tuberculosis following use of a tumor necrosis factor-alpha inhibitor

• Chung KB
• Lee EY
• Im JP
• Han SK
• Yim JJ

• KMID: 1501772
• DOI: http://doi.org/10.3904/kjim.2013.28.2.174

Abstract

BACKGROUND/AIMS
Individuals being treated with tumor necrosis factor (TNF)-alpha inhibitors are at increased risk of developing tuberculosis (TB). We determined the clinical characteristics and treatment response of patients who developed TB after using TNF-alpha inhibitors.
METHODS
Patients with TB detected within 12 months of the initiation of TNF-alpha inhibitor treatment were included, if seen from January 1, 2000 to August 31, 2011. We retrospectively reviewed the clinical records, results of bacteriological examinations, and radiographs of the included patients and the response to anti-TB treatment.
RESULTS
We indentified seven cases of TB in 457 patients treated with TNF-alpha inhibitors during the study period. TB developed a median of 123 days (range, 48 to 331) after the first dose of TNF-alpha inhibitor. Pulmonary TB, including TB pleuritis, was diagnosed in three patients and extrapulmonary TB in four. Favorable treatment outcomes were achieved in six of seven patients.
CONCLUSIONS
Among the TNF-alpha inhibitor users who contracted TB, extrapulmonary sites were common and the treatment response was satisfactory.

Keyword

Tumor necrosis factor-alpha; Tuberculosis; Mycobacterium

MeSH Terms

Adult
Aged
Antitubercular Agents/therapeutic use
Female
Humans
*Immunocompromised Host
Immunosuppressive Agents/*adverse effects
Interferon-gamma Release Tests
Male
Middle Aged
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Tuberculin Test
Tuberculosis/diagnosis/drug therapy/*immunology/microbiology
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
Antitubercular Agents
Immunosuppressive Agents
Tumor Necrosis Factor-alpha