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KMID : 0363220220600100631
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Korean Journal of Dermatology
2022 Volume.60 No. 10 p.631 ~ p.639
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Latent Tuberculosis Infection in Adult Patients with Severe Psoriasis Treated with Biologics at a Single Medical Center
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Choi Ki-Hwa
Eun Dae-Hwi
Lee Ji-Yeoun
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Abstract
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Background: Biologics have been increasingly used in the treatment of severe psoriasis. However, evidenceregarding the results of tuberculosis (TB) screening and risk of latent tuberculosis infection (LTBI) during treatmentwith biologics is conflicting.
Objective: We aimed to assess the prevalence of LTBI in patients with severe psoriasis who were treated withbiologics (anti-tumor necrosis factor-α, interleukin [IL]-12/23, IL-17, and IL-23) and to evaluate the rate of conversionof interferon-gamma release assay (IGRA) during treatment with biologics at a single medical center.
Methods: We retrospectively reviewed the medical records of patients with severe psoriasis who were treated withbiologics (n=118) and had results for ≥2 IGRA (n=76). Data including demographics, age, sex, previous therapy forpsoriasis, and type of ongoing treatment were collected for each patient.
Results: Among the 118 patients included in the study, 30 (25.4%) were diagnosed with LTBI before the initiationof biologics, 25 (83.3%) were male, and only five patients were aged below 40 years. After treatment with biologicsfor an average duration of 2.4 years, there was no active tuberculosis infection in 76 patients, but eight patients(10.5%) showed positive conversion of IGRA.
Conclusion: Altogether, 10.5% of the patients with psoriasis who were undergoing treatment with biologicsexhibited IGRA conversion. Periodic follow-up is crucial to avoid severe infectious complications during prolongeduse of these agents, especially in patients with risk factors for tuberculosis or in patients aged above 50 years.
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KEYWORD
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Biologics, Latent tuberculosis infection, Psoriasis
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