Systematic review confirms elevated TB risk in TNF inhibitor users
medwireNews: Patients with rheumatic diseases receiving treatment with tumor necrosis factor (TNF) inhibitors have an elevated risk for developing tuberculosis (TB), show the results of a systematic review.
In their analysis of 52 observational studies including a total of 98,483 patients exposed to at least one TNF inhibitor (infliximab, etanercept, adalimumab, golimumab, or certolizumab pegol), the study authors identified 947 cases of TB, predominantly pulmonary, giving a cumulative incidence rate of 9.62 cases per 1000 exposed patients.
This rate is “approximately 12 to 25 times greater than that of the general population,” write Natália Sarzi Sartori (Universidade Federal do Rio Grande do Sul, Brazil) and team in Clinical Rheumatology. On average, patients developed TB 18 months after starting TNF inhibitor therapy.
Sartori and colleagues found no significant differences in TB incidence rates among patients with different rheumatic diseases, but the incidence was significantly higher in South America and Asia than North America and Europe.
“The incidence of TB in patients exposed to anti-TNF therapy is directly linked to the incidence of TB in the general population,” they say, noting that Asia and South America have a higher overall incidence of TB than other regions.
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