Clinical Characteristics of Tuberculosis Patients Who Were on Therapy of Tumor Necrozing Factor Alpha Antagonists

Abstract

SESSION TITLE: Tuberculosis PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Tuberculosis prevelance of patients who were on therapy of tumor necrozing factor antagonists (TNF) was 449/100.000. Here we evaluated the clinical characteristics of our patients who had tuberculosis infection during the therapy of TNF antagonists.METHODS: Patientâ s demographics, smoking history, underlying disease and disease duration, history of tuberculosis (contact, tuberculin skin test, prophylaxis of isoniazid), type of TNF antagonist and duration and the other immunsupressive drugs were recorded.RESULTS: Files of 1794 patients followed between August 2005-June 2013 were evaluated. Tuberculosis was detected in 20 patients (%1). Most of our patients were male (%65, n=13). Mean age was 42.3±10.41years. Most of them were smokers (%70, 18.8±14.5 pack-year) and %35 were active smokers. Endication for TNF antagonists were; ankylosing spondylitis (%40, n=8), Crohn disease (%25, n=5), rheumatoid arthritis (%10, n=2), Behcet disease (%10, n=2), psoriatic arthritis (%10, n=2), hidroadenitis suppurativa (%5, n=1). Infliximab is the most common used (%50, n=10) TNF antagonist. Contact with tuberculosis was reported in 25% (n=5) of our patients. Only one patient reported tuberculosis disease in the past history. All patients had TST and chest graphy before TNF therapy. Patients with TST â ¥5 mm and fibrotic lesion sequelae on chest graphy were given p.o 300mg isoniazid prophylaxis for 9 months (%90, n=17). Baseline TST was 9.7±6.7. Tuberculosis was growth 25.1±24.9 months after TNF antagonist usage. Most of our patients had pulmonary tuberculosis (% 65, n=13) MOTT was growth in one of these patientâ culture. Seven patients had extrapulmonary tuberculosis. Immunsupressive therapy (methotrexate, azathioprine, cyclosporine) were given to 55% of the patients.CONCLUSIONS: Although isoniazid chemoprophylaxis was given to the patient using TNF antagonists. Tuberculosis disease was detected in high frequency.CLINICAL IMPLICATIONS: Tuberculosis prevelance of patients who were on therapy of tumor necrozing factor antagonists was 449/100.000. In our study population tuberculosis prevelance was higher than the literatüre although isoniazid chemoprophylaxis was given.DISCLOSURE: The following authors have nothing to disclose: Tulin Cagatay, Zuleyha Bingol, Zeynep Yegin, Gulfer Okumus, Esen Kiyan, Orhan Arseven, Feyza Erkan, Ziya Gulbaran, Mustafa Erelel, Turhan Ece, Zeki KilicaslanNo Product/Research Disclosure Information