J Korean Med Sci.  2007 Oct;22(5):779-783. 10.3346/jkms.2007.22.5.779.

Diagnosis and Treatment of Latent Tuberculosis Infection in Arthritis Patients Treated with Tumor Necrosis Factor Antagonists in Korea

• Yun JW
• Lim SY
• Suh GY
• Chung MP
• Kim H
• Kwon OJ
• Cha HS
• Koh EM
• Koh WJ

• KMID: 1713280
• DOI: http://doi.org/10.3346/jkms.2007.22.5.779

Abstract

Tumor necrosis factor (TNF) is essential for host defense against Mycobacterium tuberculosis, and the risk of reactivation of latent tuberculosis infection (LTBI) increases with anti-TNF therapy. This study estimated the prevalence of LTBI and evaluated the safety and completion rate of short-course therapy with isoniazid plus rifampin for 3 months to treat LTBI in a cohort of Korean arthritis patients before initiating anti-TNF therapy. We retrospectively studied the files of 112 consecutive patients to evaluate LTBI before starting anti-TNF drugs. Screening tests were performed, including a tuberculin skin test and chest radiography. LTBI treatment was indicated in 41 patients (37%). Of these, three patients refused the LTBI treatment. Of the 38 patients who underwent LTBI treatment, 36 (95%) took isoniazid plus rifampin for 3 months. Six patients (16%) showed transient elevations of liver enzymes during the LTBI treatment. Overall, 35 patients (92%) completed the LTBI treatment as planned. In conclusion, LTBI was diagnosed in one-third of Korean arthritis patients before initiating anti-TNF therapy. A high percentage of these patients completed 3 months of LTBI treatment with isoniazid plus rifampin without serious complications.

Keyword

Spondylitis, Ankylosing; Isoniazid; Arthritis, Rheumatoid; Rifampin; Tuberculin Test; Tuberculosis; Tumor Necrosis Factor-alpha

MeSH Terms

Adult
Antibiotics, Antitubercular/pharmacology
Arthritis, Rheumatoid/*complications/*diagnosis/*drug therapy
Female
Humans
Korea
Male
Middle Aged
Retrospective Studies
Rifampin/pharmacology
Spondylitis/metabolism
Spondylitis, Ankylosing/complications/diagnosis/drug therapy
Tuberculin Test
Tuberculosis/*complications/*diagnosis/*drug therapy
Tumor Necrosis Factor-alpha/*antagonists & inhibitors

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