title: Incidence of tuberculosis infection in psoriatic patients on anti-TNF therapy: report of a case series with 144 patients.
abstract: BACKGROUND
  Worldwide clinical trials and post-marketing surveillance data have demonstrated an increased incidence of tuberculosis (TB) disease associated with antitumour necrosis factor (anti-TNF) agents. The majority of these cases are presumed to result from a reactivation of latent disease, while the rate of new infections is unknown. A study was performed to evaluate th incidence of latent tuberculosis infection (LTBI) in psoriatic patients screened for biological therapy in a high-incidence area, such as Madrid, Spain.
  
  
  METHODS
  One hundred and forty-four patients with moderate-to-severe psoriasis treated with anti-TNF agents were recruited. All of them were screened for active TB or LTBI before therapy. The screening included a detailed medical study, physical examination, chest X-ray, tuberculin skin test (TST) with purified protein derivative and re-TST.
  
  
  RESULTS
  A total of 42 (29%) patients were diagnosed with LTBI based on a positive TST or re-TST, and/or signs of past TB in the chest X-ray. All of them received chemoprophylaxis with isoniazide. One patient developed a primary active lymphnode TB.
  
  
  CONCLUSIONS
  This is the first study to underscore the incidence of LTBI in patients with psoriasis treated with anti-TNF therapy in the Spanish population. We support that the use of TST is still reliable and an effective diagnostic method for the detection of LTBI in anti-TNF therapy.
authors.affiliation: Department of Dermatology, Complejo Hospitalario Toledo, Spain Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain. anai.sanchezmoya@yahoo.es
authors.forename: A I
authors.initials: AI
authors.lastname: Sánchez-Moya
authors.forename: E
authors.initials: E
authors.lastname: Dauden
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000995:Antitubercular Agents / Q000627:therapeutic use; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D000069285:Infliximab; D007538:Isoniazid / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011565:Psoriasis / Q000188:drug therapy*; D011736:Pyridoxine / Q000627:therapeutic use; D011859:Radiography; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D013030:Spain / Q000453:epidemiology; D014374:Tuberculin Test; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014803:Vitamin B Complex / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000995:Antitubercular Agents; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D014803:Vitamin B Complex; D000069285:Infliximab; D000068879:Adalimumab; D011736:Pyridoxine; D000068800:Etanercept; D007538:Isoniazid