Tags

Type your tag names separated by a space and hit enter

Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors.
Ther Adv Musculoskelet Dis. 2020; 12:1759720X20930116.TA

Abstract

Patients with autoimmune rheumatic diseases (ARD) have an increased risk for tuberculosis (TB). The use of tumor necrosis factor inhibitors (TNFi) and glucocorticoids in these patients has been associated with an increased prevalence of latent TB reactivation. Over the last few years, several biologic disease-modifying anti-rheumatic drugs (bDMARDs), other than TNFi (e.g. rituximab, abatacept, tocilizumab, secukinumab) and targeted synthetic DMARDs (tsDMARDs) [e.g. apremilast, Janus kinase (JAK) inhibitors] have been used for the treatment of patients with ARD. For many of these drugs, especially the newer ones like JAK inhibitors or antibodies against interleukin (IL)-23, most data stem from randomized clinical trials and few are available from real life clinical experience. We sought to review the current evidence for TB risk in patients with ARD treated with tsDMARDs or bDMARDs, other than TNFi. It seems that some of these drugs are associated with a lower TB risk, indirectly compared with TNFi treatment. In fact, it appears that rituximab, apremilast and inhibitors of IL-17 and IL-23 might be safer, while more data are needed for JAK inhibitors. As seen in TNFi, risk for TB is more pronounced in TB-endemic areas. Screening for latent TB must precede initiation of any tsDMARDs or bDMARDs. The growing use of non-TNFi agents has raised the need for more real-life studies that would compare the risk for TB between TNFi and other treatment modalities for ARD. Knowledge about the TB-safety profile of these drugs could help in the decision of drug choice in patients with confirmed latent TB infection or in TB endemic areas.

Authors+Show Affiliations

Rheumatology Department, 417 Army Share Fund Hospital (NIMTS), Monis Petraki 10-12, Athens, 11521, Greece.Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.Rheumatology Department, 417 Army Share Fund Hospital (NIMTS), Athens, Greece.Rheumatology Unit, First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32612710

Citation

Evangelatos, Gerasimos, et al. "Tuberculosis and Targeted Synthetic or Biologic DMARDs, Beyond Tumor Necrosis Factor Inhibitors." Therapeutic Advances in Musculoskeletal Disease, vol. 12, 2020, p. 1759720X20930116.
Evangelatos G, Koulouri V, Iliopoulos A, et al. Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors. Ther Adv Musculoskelet Dis. 2020;12:1759720X20930116.
Evangelatos, G., Koulouri, V., Iliopoulos, A., & Fragoulis, G. E. (2020). Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors. Therapeutic Advances in Musculoskeletal Disease, 12, 1759720X20930116. https://doi.org/10.1177/1759720X20930116
Evangelatos G, et al. Tuberculosis and Targeted Synthetic or Biologic DMARDs, Beyond Tumor Necrosis Factor Inhibitors. Ther Adv Musculoskelet Dis. 2020;12:1759720X20930116. PubMed PMID: 32612710.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tuberculosis and targeted synthetic or biologic DMARDs, beyond tumor necrosis factor inhibitors. AU - Evangelatos,Gerasimos, AU - Koulouri,Vasiliki, AU - Iliopoulos,Alexios, AU - Fragoulis,George E, Y1 - 2020/06/22/ PY - 2019/09/04/received PY - 2020/05/07/accepted PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - Tumor necrosis factor inhibitor KW - autoimmune KW - biologic DMARDs KW - rheumatic disease KW - targeted synthetic DMARDs KW - tuberculosis SP - 1759720X20930116 EP - 1759720X20930116 JF - Therapeutic advances in musculoskeletal disease JO - Ther Adv Musculoskelet Dis VL - 12 N2 - Patients with autoimmune rheumatic diseases (ARD) have an increased risk for tuberculosis (TB). The use of tumor necrosis factor inhibitors (TNFi) and glucocorticoids in these patients has been associated with an increased prevalence of latent TB reactivation. Over the last few years, several biologic disease-modifying anti-rheumatic drugs (bDMARDs), other than TNFi (e.g. rituximab, abatacept, tocilizumab, secukinumab) and targeted synthetic DMARDs (tsDMARDs) [e.g. apremilast, Janus kinase (JAK) inhibitors] have been used for the treatment of patients with ARD. For many of these drugs, especially the newer ones like JAK inhibitors or antibodies against interleukin (IL)-23, most data stem from randomized clinical trials and few are available from real life clinical experience. We sought to review the current evidence for TB risk in patients with ARD treated with tsDMARDs or bDMARDs, other than TNFi. It seems that some of these drugs are associated with a lower TB risk, indirectly compared with TNFi treatment. In fact, it appears that rituximab, apremilast and inhibitors of IL-17 and IL-23 might be safer, while more data are needed for JAK inhibitors. As seen in TNFi, risk for TB is more pronounced in TB-endemic areas. Screening for latent TB must precede initiation of any tsDMARDs or bDMARDs. The growing use of non-TNFi agents has raised the need for more real-life studies that would compare the risk for TB between TNFi and other treatment modalities for ARD. Knowledge about the TB-safety profile of these drugs could help in the decision of drug choice in patients with confirmed latent TB infection or in TB endemic areas. SN - 1759-720X UR - https://www.unboundmedicine.com/medline/citation/32612710/Tuberculosis_and_targeted_synthetic_or_biologic_DMARDs,_beyond_tumor_necrosis_factor_inhibitors L2 - http://journals.sagepub.com/doi/full/10.1177/1759720X20930116?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.