Preventive therapy for tuberculosis in rheumatological patients undergoing therapy with biological drugs

Expert Review of Anti-infective Therapy
Delia GolettiFabrizio Cantini

Abstract

Latent tuberculosis infection (LTBI) accounts for almost a quarter of the world population, and, in 5-10% of the subjects with impaired immune-response against M. tuberculosis growth, it may progress to active tuberculosis (TB). In this review, we focus on the need to propose a screening for LTBI including preventive therapy offer in rheumatic patients undergoing therapy with biological drugs. Areas covered: We report on evidence that biologics are associated with an increased risk of active TB reactivation. This effect seems to be mainly limited to treatment with anti-tumor necrosis factor (TNF) agents, while non-anti-TNF-targeted biologics are not likely associated to any increased risk. We introduce the concept that the patients' coexisting host-related risk factors, such as comorbidities, are crucial to identify those at higher risk to reactivate TB. We report that preventive TB therapy is well tolerated in patients treated with biological drugs. Expert commentary: Availability of non-anti-TNF targeted biologics, that are not associated with an increased risk of TB reactivation, offers a great opportunity to tailor a therapeutic intervention at low/absent TB risk. After proper LTBI screening investigations, preventive TB th...Continue Reading

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Citations

Nov 6, 2018·Expert Review of Anti-infective Therapy·Mario Fernández-Ruiz, José María Aguado
May 14, 2020·Expert Opinion on Drug Safety·Fabiola AtzeniIgnazio Francesco Masala
Dec 20, 2019·Expert Review of Clinical Immunology·Ying-Ming Chiu, Der-Yuan Chen
May 13, 2020·Expert Opinion on Drug Safety·Davide Fiore BavaroAnnalisa Saracino
Sep 13, 2020·Emerging Infectious Diseases·Giovanni Battista MiglioriDelia Goletti
Jun 21, 2020·Current Cardiology Reports·Enrico TombettiCarla Carnovale
Mar 18, 2020·Zeitschrift für Rheumatologie·Stephan Blüml
Nov 19, 2020·The Journal of Infectious Diseases·Caio César Barbosa BomfimMaria Regina D'Império Lima
Jul 29, 2021·Current Cardiology Reports·Emanuele BizziAntonio Brucato
Aug 28, 2021·Frontiers in Immunology·Elisa PetruccioliDelia Goletti
Oct 3, 2021·Current Cardiology Reports·Alessandra VecchiéAldo Bonaventura

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