title: Diagnosis and treatment of latent tuberculosis infection in arthritis patients treated with tumor necrosis factor antagonists in Korea.
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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Yun
authors.forename: Seong Yong
authors.initials: SY
authors.lastname: Lim
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Hoon-Suk
authors.initials: HS
authors.lastname: Cha
authors.forename: Eun-Mi
authors.initials: EM
authors.lastname: Koh
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
mesh_terms: D000328:Adult; D000904:Antibiotics, Antitubercular / Q000494:pharmacology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012293:Rifampin / Q000494:pharmacology; D013166:Spondylitis / Q000378:metabolism; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014374:Tuberculin Test; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000904:Antibiotics, Antitubercular; D014409:Tumor Necrosis Factor-alpha; D012293:Rifampin