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Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test?
Aging Male 2019; :1-6AM

Abstract

Introduction: The aim of this study was to present the follow-up results of 110 patients who were given anti-tumor necrosis factor alpha (TNF-α) therapy for rheumatic and dermatologic diseases in a country with a high rates of active and latent tuberculosis bacillus infection. Material and

Methods:

Between February 2008 and January 2015, 110 cases in the age range of 23-77 who are using anti-TNF-α were included in the study retro-prospectively.

Results:

52.7% of them (n = 58) were male. The most common diagnoses were rheumatoid arthritis (42.7%) and ankylosing spondylitis (38.2%). Most frequently given treatment were infliximab 37.3% and etanercept 30.9%, respectively. The 65 patients whose first tuberculin skin test (TST) value "5 mm and above" was started daily 300 mg INH prophylaxis for 9 months but 3 patients had not been started because of refusing treatment. In only one case chemoprophylaxis has had to be interrupted because of high liver function test due to the INH prophylaxis. TST conversion was observed in 14 patients. Further follow-up, it was observed that 4 patients had TST's positivity. Isoniazide (INH) prophylaxis was started these 18 patients (42.9%). Although INH prophylaxis has been given in two patients, they developed active tuberculosis in follow-up.

Conclusion:

Considering the INH resistance in our country, all patients especially the ones with residual lesion and history of previous exposure, should be followed up closely during the anti-TNF-α treatment.

Authors+Show Affiliations

Department of Chest Disease, Afyonkarahisar State Hospital , Afyonkarahisar , Turkey.Department of Chest Disease, Duzce University , Duzce , Turkey.Department of Biostatistics and Medical Informatics, Duzce University , Duzce , Turkey.Department of Chest Disease, Duzce University , Duzce , Turkey.Department of Chest Disease, Ada Private Hospital , Istanbul , Turkey.Department of Chest Disease, Duzce University , Duzce , Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31615316

Citation

Alaşan, Fatih, et al. "Should Isoniazid Prophylaxis Be Prescribed to the Patients Under Tumor Necrosis Factor-alpha Antagonists Independent of Tuberculin Skin Test?" The Aging Male : the Official Journal of the International Society for the Study of the Aging Male, 2019, pp. 1-6.
Alaşan F, Güleç Balbay E, Cangür Ş, et al. Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test? Aging Male. 2019.
Alaşan, F., Güleç Balbay, E., Cangür, Ş., Balbay, Ö., Yılmaz Aydın, L., & Annakkaya, A. N. (2019). Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test? The Aging Male : the Official Journal of the International Society for the Study of the Aging Male, pp. 1-6. doi:10.1080/13685538.2019.1678582.
Alaşan F, et al. Should Isoniazid Prophylaxis Be Prescribed to the Patients Under Tumor Necrosis Factor-alpha Antagonists Independent of Tuberculin Skin Test. Aging Male. 2019 Oct 16;1-6. PubMed PMID: 31615316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Should isoniazid prophylaxis be prescribed to the patients under tumor necrosis factor-alpha antagonists independent of tuberculin skin test? AU - Alaşan,Fatih, AU - Güleç Balbay,Ege, AU - Cangür,Şengül, AU - Balbay,Öner, AU - Yılmaz Aydın,Leyla, AU - Annakkaya,Ali Nihat, Y1 - 2019/10/16/ PY - 2019/10/17/entrez KW - Anti TNF-alpha KW - isoniazid KW - tuberculosis SP - 1 EP - 6 JF - The aging male : the official journal of the International Society for the Study of the Aging Male JO - Aging Male N2 - Introduction: The aim of this study was to present the follow-up results of 110 patients who were given anti-tumor necrosis factor alpha (TNF-α) therapy for rheumatic and dermatologic diseases in a country with a high rates of active and latent tuberculosis bacillus infection. Material and Methods: Between February 2008 and January 2015, 110 cases in the age range of 23-77 who are using anti-TNF-α were included in the study retro-prospectively. Results: 52.7% of them (n = 58) were male. The most common diagnoses were rheumatoid arthritis (42.7%) and ankylosing spondylitis (38.2%). Most frequently given treatment were infliximab 37.3% and etanercept 30.9%, respectively. The 65 patients whose first tuberculin skin test (TST) value "5 mm and above" was started daily 300 mg INH prophylaxis for 9 months but 3 patients had not been started because of refusing treatment. In only one case chemoprophylaxis has had to be interrupted because of high liver function test due to the INH prophylaxis. TST conversion was observed in 14 patients. Further follow-up, it was observed that 4 patients had TST's positivity. Isoniazide (INH) prophylaxis was started these 18 patients (42.9%). Although INH prophylaxis has been given in two patients, they developed active tuberculosis in follow-up. Conclusion: Considering the INH resistance in our country, all patients especially the ones with residual lesion and history of previous exposure, should be followed up closely during the anti-TNF-α treatment. SN - 1473-0790 UR - https://www.unboundmedicine.com/medline/citation/31615316/Should_isoniazid_prophylaxis_be_prescribed_to_the_patients_under_tumor_necrosis_factor-alpha_antagonists_independent_of_tuberculin_skin_test L2 - http://www.tandfonline.com/doi/full/10.1080/13685538.2019.1678582 DB - PRIME DP - Unbound Medicine ER -