Risk of tuberculosis in rheumatoid arthritis and ankylosing spondylitis patients treated with tumor necrosis factor antagonists / 中华风湿病学杂志

ABSTRACT

Objective To study the risk of tuberculosis (TB) infection in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients before and after treated with tumor necrosis factor (TNF) antago- nists.Methods RA and AS patients treated with TNF antagonists infliximab and etanercept between 2003 and 2006 were followed up for the risk of TB infection.The protein purified derivative (PPD) test and chest anteroposterior and lateral view X-ray were done at screening for all these patients.Results Among 67 RA patients screened,1 was PPD positive.One patient developed right supraclavicular lymph node TB 4 months after study completion.Among 203 AS patients screened,27 patients were PPD positive,2 had calcified pul- monary TB foci and 2 had pulmonary TB.PPD positive rates and calcified TB foci or active TB found in RA and AS patients screened were significantly lower than national TB infection rates and prevalence (P＜0.01). Conclusion In this short-term clinical observation,increased risk of TB infection was not found after TNF antagonists treatment in RA and AS patients.However,it is necessary to screen patients for signs of TB infec- tion before TNF antagonists treatment.