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Safety of Resuming Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis Patients Concomitant with the Treatment of Active Tuberculosis: A Retrospective Nationwide Registry of the Korean Society of Spondyloarthritis Research

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Author(s)
Hye Won KimSeong Ryul KwonKyong-Hee JungSeong-Kyu KimHan Joo BaekMi Ryung SeoSo-Young BangHye-Soon LeeChang-Hee SuhJu Yang JungChang- Nam SonSeung Cheol ShimSang-Hoon LeeSeung-Geun LeeYeon-Ah LeeEun Young LeeTae-Hwan KimYong-Gil Kim
Keimyung Author(s)
Son, Chang Nam
Department
Dept. of Internal Medicine (내과학)
Journal Title
PLoS One
Issued Date
2016
Volume
11
Issue
4
Abstract
Backgrounds
Patients who develop an active tuberculosis infection during tumor necrosis factor (TNF)
inhibitor treatment typically discontinue TNF inhibitor and receive standard anti-tuberculosis
treatment. However, there is currently insufficient information on patient outcomes following
resumption of TNF inhibitor treatment during ongoing anti- tuberculosis treatment. Our
study was designed to investigate the safety of resuming TNF inhibitors in ankylosing spondylitis
(AS) patients who developed tuberculosis as a complication of the use of TNF
inhibitors.
Methods
Through the nationwide registry of the Korean Society of Spondyloarthritis Research, 3929
AS patients who were prescribed TNF inhibitors were recruited between June 2003 and
June 2014 at fourteen referral hospitals. Clinical information was analyzed about the
patients who experienced tuberculosis after exposure to TNF inhibitors. The clinical features
of resumers and non-resumers of TNF inhibitors were compared and the outcomes of
tuberculosis were surveyed individually.
Findings
Fifty-six AS patients were treated for tuberculosis associated with TNF inhibitors. Among
them, 23 patients resumed TNF inhibitors, and these patients were found to be exposed to
TNF inhibitors for a longer period of time and experienced more frequent disease flare-up
after discontinuation of TNF inhibitors compared with those who did not resume. Fifteen
patients resumed TNF inhibitors during anti-tuberculosis treatment (early resumers) and 8
after completion of anti-tuberculosis treatment (late resumers). Median time to resuming
TNF inhibitor from tuberculosis was 3.3 and 9.0 months in the early and late resumers,
respectively. Tuberculosis was treated successfully in all resumers and did not relapse in
any of them during follow-up (median 33.8 [IQR; 20.8–66.7] months).
Conclusions
Instances of tuberculosis were treated successfully in our AS patients, even when given
concomitantly with TNF inhibitors. We suggest that early resumption of TNF inhibitors in AS
patients could be safe under effective coverage of tuberculosis.
Keimyung Author(s)(Kor)
손창남
Publisher
School of Medicine
Citation
Hye Won Kim et al. (2016). Safety of Resuming Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis Patients Concomitant with the Treatment of Active Tuberculosis: A Retrospective Nationwide Registry of the Korean Society of Spondyloarthritis Research. PLoS One, 11(4), e0153816–e0153816. doi: 10.1371/journal.pone.0153816
Type
Article
ISSN
1932-6203
DOI
10.1371/journal.pone.0153816
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33287
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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