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KMID : 0191120180330470292
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Journal of Korean Medical Science
2018 Volume.33 No. 47 p.292 ~ p.292
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Incidence of Active Tuberculosis within One Year after Tumor Necrosis Factor Inhibitor Treatment according to Latent Tuberculosis Infection Status in Patients with Inflammatory Bowel Disease
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Kang Ji-Eun
Jeong Dae-Hyun
Han Min-Kyu
Yang Suk-Kyun
Byeon Jeong-Sik
Ye Byong-Duk
Park Sang-Hyoung
Hwang Sung-Wook
Shim Tae-Sun
Jo Kyung-Wook
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Abstract
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Background: We investigated the incidence of active tuberculosis among patients with inflammatory bowel disease (IBD) treated with tumor necrosis factor (TNF) inhibitors, with or without latent tuberculosis infection (LTBI).
Methods: The study was performed at a Korean tertiary referral center between January 2011 and June 2017. In total, 740 patients with IBD who underwent LTBI screening tests and were followed-up for ≥ 1 year after TNF inhibitor treatment initiation were enrolled. LTBI was detected on the basis of tuberculin skin test results, interferon-gamma release assay results, chest X-ray findings, and previous tuberculosis treatment history. The patients were classified into LTBI (n = 84) or non-LTBI (n = 656) group. The risk of developing tuberculosis in each group was assessed on the basis of standardized incidence ratio (SIR) and 95% confidence interval (CI) for active tuberculosis.
Results: Mean patient age was 33.1 years, and patients with Crohn's disease were predominant (80.7%). Within 1 year after the initiation of TNF inhibitor treatment, 1 patient in the LTBI group (1/84; 1.2%) and 7 patients in the non-LTBI group (7/656; 1.1%) developed active tuberculosis. The overall 1-year incidence of tuberculosis among the patients was significantly higher than that among the general population (SIR, 14.0; 95% CI, 7.0?28.0), and SIR was not affected by LTBI status (LTBI group: 14.5, 95% CI, 2.0?102.6; non-LTBI group: 14.0, 95% CI, 6.7?29.4).
Conclusion: Patients with IBD undergoing TNF inhibitor treatment showed a higher 1-year incidence of tuberculosis than the general population irrespective of LTBI status.
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KEYWORD
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Tuberculosis, Inflammatory Bowel Disease, TNF Inhibitor
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