Tuberculosis frequency in patients taking TNF-alpha blokers Anti TNF-alfa kullanan hastalarda tüberküloz sıklıǧı

Doǧan C., Kiral Dr. N., Cömert S. Ş. , Fidan A., Çaǧlayan B., Salepçi B.

Turk Toraks Dergisi, vol.13, no.3, pp.93-98, 2012 (Peer-Reviewed Journal) identifier

  • Publication Type: Article / Article
  • Volume: 13 Issue: 3
  • Publication Date: 2012
  • Doi Number: 10.5152/ttd.2012.22
  • Journal Name: Turk Toraks Dergisi
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.93-98
  • Keywords: Ankylosing, Arthritis, Rheumatoid, Spondylitis, Tuberculin test, Tuberculosis, Tumor necrosis factor-alpha


Objective: To evaluate tuberculosis frequency in patients who take tumor necrosis factor alpha (TNF-α) inhibitors for Collagen Vascular Disease (CVD). Materials and Methods: Patients who actively use or were planned to use TNF-α inhibitors for CVD between June 2007-February 2010 were prospectively included in the study.All patients had a physical examination, chest x-ray and the Tuberculin Skin Test (TST). Sputum smear and culture for acid fast bacilli (AFB) was performed in patients with a suspicious lesion on chest x-ray. During follow-up, physical examination, chest x-ray and sputum smear for AFB in indicated cases were performed every 3 months. Tuberculosis was diagnosed with microbiological, radiological and histopathological methods.In case of pulmonary or extrapulmonary tuberculosis,TNF-α inhibitor medication was stopped and anti-tuberculosis therapy was began. Results: A total of 179 patients were included in the study, 91 were female and 88 were male wth a mean age of 42.8±12.0. In 141 patients, TNF-α inhibitor therapy was begun in the study although 38 were taking TNF-α inhibitor medication at the beginning of the study. The median follow-up period was 17 months and 2 (1.1%) patients were diagnosed to have active tuberculosis during the study period. The TST was found to be 5-9 mm in 15% and >10 mm in 53.3% of the patients.There was a successful tuberculosis therapy history in 5 patients and at least 1 BCG scar was seen in 67 patients.In our series, 70.9% of the patients had chemoprophylaxis during the study period and new tuberculosis was diagnosed in 2 patients, consisting of one miliary tuberculosis and one pleural tuberculosis. Tuberculosis was diagnosed in 1.1% of TNF-alpha taking patients in our series. Conclusion: It is recomended that the patients taking anti TNF treatment should be evaluated and followed up regularly for tuberculosis during the treatment.