TITLE

Tuberculosis following the Use of Etanercept, a Tumor Necrosis Factor Inhibitor

AUTHOR(S)
Mohan, Aparna K.; Coté, Timothy R.; Block, Joel A.; Manadan, Augustine M.; Siegel, Jeffrey N.; Braun, M. Miles
PUB. DATE
August 2004
SOURCE
Clinical Infectious Diseases;8/1/2004, Vol. 39 Issue 3, p295
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Infliximab, a tumor necrosis factor (TNF) antagonist, is associated with tuberculosis (TB), but it is unknown whether this phenomenon is true of all TNF antagonists. We reviewed 25 cases of TB due to another TNF antagonist, etanercept, that were reported to the US Food and Drug Administration (FDA) between November 1998 and March 2002. Such cases are sometimes incomplete and are subject to underreporting. Fifteen patients received other immunosuppressive medications. The median interval between the receipt of the first dose of etanercept and the diagnosis of TB was 11.5 months. Thirteen patients had extrapulmonary TB at the time of diagnosis. Diagnosis was made on the basis of culture results for 12 patients, biopsy findings for 9, and sputum staining for 4. There were 2 deaths, 1 of which was directly attributed to TB. The estimated number of TB cases reported to the FDA for each person-year of treatment with etanercept (i.e., the "reporting rate") among patients with rheumatoid arthritis (RA) was ∼10 cases/100,000 patient-years of exposure. Clinicians considering etanercept for patients with RA should be alert to the possibility of the occurrence of TB, sometimes with an unusual extrapulmonary presentation. It is unclear whether etanercept therapy increases the risk of TB beyond the elevated TB rates already documented for patients with RA.
ACCESSION #
13919947

 

Related Articles

  • Tumor Necrosis Factor Blockers and Reactivation of Latent Tuberculosis. Keane, Joseph // Clinical Infectious Diseases;8/1/2004, Vol. 39 Issue 3, p300 

    It is informed that patients with rheumatoid arthritis may be at increased risk of reactivation of infectious diseases that normally remain latent in granuloma. It is opined that this reactivation may occur because of immunosuppressive treatments, such as steroids or monoclonal anti-tumor...

  • Miscellaneous.  // Current Medical Literature: Rheumatology;2008, Vol. 27 Issue 3, p95 

    The article discusses research being done on whether tuberculosis (TB) cases associated with anti-tumor necrosis factor (TNF) agents are related to reactivation of latent TB or progression of new TB infections. It references a study by R. S. Wallis et al which appeared in a 2008 issue of...

  • The Changing Face of Spondyloarthropathies Under TNF α Blockade. Elkayam, Ori; Litinsky, Irena; Levartovsky, David; Caspi, Dan // Open Rheumatology Journal;2008, Vol. 2, p53 

    Objectives: Tumor necrosis factor alpha (TNF-α) therapy has been implicated in the development of autoimmune diseases. Our aim was to describe three patients with spondyloarthropathies who responded to infliximab, a chimeric monoclonal antibody specific for TNF-α, but developed new...

  • Tumour necrosis factor-α inhibitors and the reactivation of latent tuberculosis infection. Long, Richard; Gardam, Michael // CMAJ: Canadian Medical Association Journal;4/29/2003, Vol. 168 Issue 9, p1153 

    Discusses tumor necrosis factor-&alpha (TNF-α); inhibitors and the reactivation of latent tuberculosis (TB) infection. Use of infliximab, a chimeric antibody that targets TNF-α, for treatment of Crohn's disease or rheumatoid arthritis that is not responding to other anti-inflammatory...

  • TNF inhibitor use associated with granulomatous infectious disease; infliximab poses greatest risk.  // Formulary;Jul2004, Vol. 39 Issue 7, p341 

    Reports on a study published in the journal "Clinical Infectious Diseases" indicating that tumor necrosis factor (TNF) antagonists increase the risk of granulomatous infectious disease, including tuberculosis. Comparison of the risk of infection in patients who received infliximab and...

  • Association between tumor necrosis factor alpha- 238G/a polymorphism and tuberculosis susceptibility: a meta-analysis study. Zhijiao Zhang; Hang Zhu; Xudi Pu; Siying Meng; Fan Zhang; Lei Xun; Qin Liu; Yang Wang // BMC Infectious Diseases;2012, Vol. 12 Issue 1, p328 

    Background: Tumor necrosis factor alpha (TNF-α) plays a key role in the containment of tuberculosis. The relationship between the TNF -238G/A polymorphism and tuberculosis susceptibility remains inconclusive. A comprehensive meta-analysis was made to provide a more precise estimate of the...

  • Role of TNF-Alpha, IFN-Gamma, and IL-10 in the Development of Pulmonary Tuberculosis. Cavalcanti, Yone Vila Nova; Brelaz, Maria Carolina Accioly; de Andrade Lemoine Neves, Juliana Kelle; Ferraz, José Candido; Pereira, Valéria Rêgo Alves // Pulmonary Medicine;2012, p1 

    Host immune response against Mycobacterium tuberculosis is mediated by cellular immunity, in which cytokines and Th1 cells play a critical role. In the process of control of the infection by mycobacteria, TNF-alpha seems to have a primordial function. This cytokine acts in synergy with...

  • Macrophages Play a Dual Role during Pulmonary Tuberculosis in Mice. Leemans, Jaklien C.; Thepen, Theo; Weijer, Sebastiaan; Florquin, Sandrine; Van Rooijen, Nico; Van de Winkel, Jan G.; Van der Poll, Tom // Journal of Infectious Diseases;1/1/2005, Vol. 191 Issue 1, p65 

    Pulmonary macrophages provide the preferred hiding and replication site of Mycobacterium tuberculosis but display antimicrobial functions. This raises questions regarding the role of macrophages during tuberculosis. We depleted lungs of activated macrophages (activated macrophage mice) and...

  • Successful treatment of chronic tophaceous gout with infliximab (Remicade). Fiehn, Christoph; Zeier, Martin // Rheumatology International;Jan2006, Vol. 26 Issue 3, p274 

    The article presents a case study in rheumatology on the treatment of chronic tophaceous gout with infliximab. In the case of a patient with refractory chronic tophaceous gout treatment with infliximab resulted in a fast improvement of the polyarticular inflammation. However, parameters of...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics