TY - JOUR
T1 - The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement
AU - Solovic, I.
AU - Sester, M.
AU - Gomez-Reino, J.J.
AU - Rieder, H.L.
AU - Ehlers, S.
AU - Milburn, H.J.
AU - Kampmann, B.
AU - Hellmich, B.
AU - Groves, R.
AU - Schreiber, S.
AU - Wallis, R.S.
AU - Sotgiu, G.
AU - Scholvinck, E.H.
AU - Goletti, D.
AU - Zellweger, J.P.
AU - Diel, R.
AU - Carmona, L.
AU - Bartalesi, F.
AU - Ravn, P.
AU - Bossink, A.
AU - Duarte, R.
AU - Erkens, C.
AU - Clark, J.
AU - Migliori, G.B.
AU - Lange, C.
PY - 2010
Y1 - 2010
N2 - Anti-tumour necrosis factor (TNF) monoclonal antibodies or soluble TNF receptors have become an invaluable treatment against chronic inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel disease and psoriasis. Individuals who are treated with TNF antagonists are at an increased risk of reactivating latent infections, especially tuberculosis (TB). Following TNF antagonist therapy, the relative risk for TB is increased up to 25 times, depending on the clinical setting and the TNF antagonist used. Interferon-gamma release assays or, as an alternative in individuals without a history of bacille Calmette-Guerin vaccination, tuberculin skin testing is recommended to screen all adult candidates for TNF antagonist treatment for the presence of latent infection with Mycobacterium tuberculosis. Moreover, paediatric practice suggests concomitant use of both the tuberculin skin test and an interferon-gamma release assay, as there are insufficient data in children to recommend one test over the other. Consequently, targeted preventive chemotherapy is highly recommended for all individuals with persistent M. tuberculosis-specific immune responses undergoing TNF antagonist therapy as it significantly reduces the risk of progression to TB. This TBNET consensus statement summarises current knowledge and expert opinions and provides evidence-based recommendations to reduce the TB risk among candidates for TNF antagonist therapy
AB - Anti-tumour necrosis factor (TNF) monoclonal antibodies or soluble TNF receptors have become an invaluable treatment against chronic inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel disease and psoriasis. Individuals who are treated with TNF antagonists are at an increased risk of reactivating latent infections, especially tuberculosis (TB). Following TNF antagonist therapy, the relative risk for TB is increased up to 25 times, depending on the clinical setting and the TNF antagonist used. Interferon-gamma release assays or, as an alternative in individuals without a history of bacille Calmette-Guerin vaccination, tuberculin skin testing is recommended to screen all adult candidates for TNF antagonist treatment for the presence of latent infection with Mycobacterium tuberculosis. Moreover, paediatric practice suggests concomitant use of both the tuberculin skin test and an interferon-gamma release assay, as there are insufficient data in children to recommend one test over the other. Consequently, targeted preventive chemotherapy is highly recommended for all individuals with persistent M. tuberculosis-specific immune responses undergoing TNF antagonist therapy as it significantly reduces the risk of progression to TB. This TBNET consensus statement summarises current knowledge and expert opinions and provides evidence-based recommendations to reduce the TB risk among candidates for TNF antagonist therapy
KW - Anti-Inflammatory Agents
KW - Antibodies, Monoclonal
KW - Antirheumatic Agents
KW - Humans
KW - Immunocompromised Host
KW - Mycobacterium tuberculosis
KW - Risk Factors
KW - Tuberculosis, Pulmonary
KW - Tumor Necrosis Factor-alpha
U2 - 10.1183/09031936.00028510
DO - 10.1183/09031936.00028510
M3 - Journal article
C2 - 20530046
SN - 0903-1936
VL - 36
SP - 1185
EP - 1206
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 5
ER -