Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents

Title
Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents
Author(s)
김경옥장병익김성국[김성국]김은수[김은수]조광범[조광범]박경식[박경식]송근암[송근암]김형욱[김형욱]김은영[김은영]이동욱[이동욱]
Keywords
TUMOR-NECROSIS-FACTOR; GAMMA RELEASE ASSAYS; RHEUMATOID-ARTHRITIS; INFLIXIMAB THERAPY; FACTOR ANTAGONISTS; MYCOBACTERIUM-TUBERCULOSIS; COMBINATION THERAPY; LATENT TUBERCULOSIS; ULCERATIVE-COLITIS; FACTOR BLOCKERS
Issue Date
201503
Publisher
BAISHIDENG PUBLISHING GROUP INC
Citation
WORLD JOURNAL OF GASTROENTEROLOGY, v.21, no.11, pp.3308 - 3316
Abstract
AIM: To evaluate the incidence and risk factors of Korean tuberculosis (TB) infection in patients with inflammatory bowel disease (IBD) undergoing anti-TNF treatment. METHODS: The data of IBD patients treated with anti-TNFs in 13 tertiary referral hospitals located in the southeastern region of Korea were collected retrospectively. They failed to show response or were intolerant to conventional treatments, including steroids or immunomodulators. Screening measures for latent TB infection (LTBI) and the incidence and risk factors of active TB infection after treatment with anti-TNFs were identified. RESULTS: Overall, 376 IBD patients treated with anti-TNF agents were recruited (male 255, mean age of anti-TNF therapy 32.5 +/- 13.0 years); 277 had Crohn's disease, 99 had ulcerative colitis, 294 used infliximab, and 82 used adalimumab. Before anti-TNF treatment, screening tests for LTBI including an interferon gamma release assay or a tuberculin skin test were performed in 82.2% of patients. Thirty patients (8%) had LTBI. Sixteen cases of active TB infection including one TB-related mortality occurred during 801 personyears (PY) follow-up (1997.4 cases per 100000 PY) after anti-TNF treatment. LTBI (OR = 5.76, 95% CI: 1.57-21.20, P = 0.008) and WBC count < 5000 mm(3) (OR = 4.5, 95% CI: 1.51-13.44, P = 0.007) during follow-up were identified as independently associated risk factors. CONCLUSION: Anti-TNFs significantly increase the risk of TB infection in Korean patients with IBD. The considerable burden of TB and marked immunosuppression might be attributed to this risk.
URI
http://hdl.handle.net/YU.REPOSITORY/33040http://dx.doi.org/10.3748/wjg.v21.i11.3308
ISSN
1007-9327
Appears in Collections:
의과대학 > 내과학교실 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE