Latent and active tuberculosis development in patients with rheumatoid arthritis receiving biologic disease-modifying antirheumatic drugs: A single-center prospective study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
    • Abstract:
      Biologics have revolutionized the treatment of rheumatoid arthritis (RA) in recent years. However, data from clinical trials and actual clinical practice have shown that biologics currently in use may constitute a risk factor for reactivation of tuberculosis (TB) in patients with latent TB infection. Therefore, screening for latent and active TB infection is mandatory before initiating biologic therapy in patients with RA. This prospective study aimed to analyze the clinical characteristics of patients with RA receiving biologic disease-modifying antirheumatic drugs at Bach Mai Hospital, Vietnam, between 2017 and 2022, and to identify factors affecting the occurrence of active and latent TB infection among these patients. Over a 12-month follow-up period, latent TB infection was confirmed in 20% of the total 180 included patients, while 3 (1.7%) patients developed active TB (one case of pulmonary, pleural, and gluteal TB each). History of TB risk factor exposure and lack of education were significantly associated with the occurrence of active and latent TB infection, with odds ratios (95% confidence intervals [CIs]) of 1.98 (1.78; 2.2) and 1.45 (1.31; 1.6), respectively. Follow-up duration and number of X-ray, computed tomography, bronchoscopy, and sputum acid-fast bacteria examinations were identified as factors that can aid in the early diagnosis of latent TB, with odds ratios (95% CIs) of 1.00 (1; 1.01), 1.02 (1; 1.05), 1.12 (1.11; 1.2), 1.11 (1.09; 1.2), and 1.13 (1.09; 1.17), respectively. Our study showed that, in countries with high TB burden like Vietnam, latent TB infection has high prevalence among patients with RA. We also provide useful information for the screening, monitoring, and treatment of latent and active TB infection in patients with RA.
      Competing Interests: The authors have declared that no competing interests exist.
      (Copyright: © 2024 Hai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
    • References:
      N Engl J Med. 2000 Nov 30;343(22):1586-93. (PMID: 11096165)
      Clin Rheumatol. 2008 Sep;27(9):1083-6. (PMID: 18320137)
      BMC Rheumatol. 2020 Oct 21;4:63. (PMID: 33094270)
      Cochrane Database Syst Rev. 2016 Aug 29;(8):CD010227. (PMID: 27571502)
      Arthritis Rheum. 2001 Oct;45(5):462-7. (PMID: 11642646)
      Rheum Dis Clin North Am. 2009 Nov;35(4):745-57, vii-viii. (PMID: 19962619)
      PLoS One. 2017 Jun 1;12(6):e0178035. (PMID: 28570568)
      PLoS One. 2018 Apr 6;13(4):e0195409. (PMID: 29624603)
      Clin Infect Dis. 2005 Jan 15;40(2):273-8. (PMID: 15655747)
      Arthritis Rheumatol. 2021 Jul;73(7):1108-1123. (PMID: 34101376)
      J Chronic Dis. 1979;32(1-2):51-63. (PMID: 447779)
      Arthritis Rheum. 2006 Jan;54(1):26-37. (PMID: 16385520)
      Lancet. 2014 Jan 25;383(9914):321-32. (PMID: 24168956)
      PLoS One. 2015 Mar 17;10(3):e0119683. (PMID: 25781999)
      Arthritis Res. 2002;4 Suppl 3:S265-72. (PMID: 12110146)
      Rheumatology (Oxford). 2005 Feb;44(2):151-6. (PMID: 15509628)
      Int J Rheumatol. 2011;2011:845496. (PMID: 22162693)
      Lancet. 2013 May 4;381(9877):1541-50. (PMID: 23515142)
      Arthritis Res Ther. 2017 Sep 2;19(1):194. (PMID: 28865493)
      Arthritis Care Res (Hoboken). 2012 May;64(5):625-39. (PMID: 22473917)
      Rheum Dis Clin North Am. 2001 May;27(2):269-81. (PMID: 11396092)
      Eur Spine J. 2006 Jan;15 Suppl 1:S17-24. (PMID: 16320034)
      Br J Rheumatol. 1988 Oct;27(5):341-3. (PMID: 3179623)
      Lancet Microbe. 2023 Jan;4(1):e20. (PMID: 36521512)
      BMC Infect Dis. 2018 Oct 12;18(1):515. (PMID: 30314453)
      Int J Infect Dis. 2019 Oct;87:21-29. (PMID: 31301458)
      Therapie. 2017 Oct;72(5):573-578. (PMID: 28318613)
      Ann Rheum Dis. 2013 Jun;72(6):875-80. (PMID: 22798565)
      Ann Rheum Dis. 2010 Jan;69(1):88-96. (PMID: 19297346)
      Ann Rheum Dis. 2009 Jun;68(6):954-60. (PMID: 18490431)
      Autoimmun Rev. 2015 Jun;14(6):503-9. (PMID: 25617816)
      Arthritis Rheum. 1988 Mar;31(3):315-24. (PMID: 3358796)
      Rheumatology (Oxford). 2016 Mar 8;55(6):1053-1065. (PMID: 26961746)
      Ann Rheum Dis. 2017 Jun;76(6):960-977. (PMID: 28264816)
      Rheumatology (Oxford). 2000 Sep;39(9):975-81. (PMID: 10986302)
      Reumatologia. 2018;56(4):228-233. (PMID: 30237627)
      BMJ. 1998 Mar 14;316(7134):811-8. (PMID: 9549450)
      MMWR Recomm Rep. 2020 Feb 14;69(1):1-11. (PMID: 32053584)
      Clin Rheumatol. 2015 Dec;34(12):2141-5. (PMID: 26497501)
      Arthritis Rheum. 2010 Sep;62(9):2569-81. (PMID: 20872595)
      Semin Arthritis Rheum. 2006 Dec;36(3):182-8. (PMID: 17045630)
      Lancet. 2002 Apr 6;359(9313):1173-7. (PMID: 11955534)
      N Engl J Med. 2011 Dec 8;365(23):2155-66. (PMID: 22150035)
      BMC Infect Dis. 2007 Oct 25;7:122. (PMID: 17961228)
    • Accession Number:
      0 (Antirheumatic Agents)
      0 (Biological Factors)
      0 (Biological Products)
    • Publication Date:
      Date Created: 20240111 Date Completed: 20240125 Latest Revision: 20240125
    • Publication Date:
      20240126
    • Accession Number:
      PMC10783715
    • Accession Number:
      10.1371/journal.pone.0295048
    • Accession Number:
      38206946