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Risk of tuberculosis reactivation with rituximab therapy

BACKGROUND: Tuberculosis (TB) is one of the world’s deadliest diseases, and one-third of the world’s population is infected with it. The link between antitumor necrosis factor therapy and reactivation of latent TB is well recognized. However, only limited studies have evaluated the risk of TB with r...

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Autores principales: Alkadi, Amjad, Alduaiji, Najla, Alrehaily, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Qassim Uninversity 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426414/
https://www.ncbi.nlm.nih.gov/pubmed/28539862
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author Alkadi, Amjad
Alduaiji, Najla
Alrehaily, Ali
author_facet Alkadi, Amjad
Alduaiji, Najla
Alrehaily, Ali
author_sort Alkadi, Amjad
collection PubMed
description BACKGROUND: Tuberculosis (TB) is one of the world’s deadliest diseases, and one-third of the world’s population is infected with it. The link between antitumor necrosis factor therapy and reactivation of latent TB is well recognized. However, only limited studies have evaluated the risk of TB with rituximab, a B-cell-targeting therapeutic agent used recently for rheumatological diseases, primarily rheumatoid arthritis. Moreover, no studies have assessed this risk in TB endemic regions with a high incidence and prevalence of TB (e.g., Saudi Arabia). OBJECTIVE: To examine the risk of acquiring TB or activating latent TB in adult patients with rheumatological disease who received rituximab therapy. METHODOLOGY: Retrospective cohort study included 60 patients at King Faisal Specialist Hospital and Research Centre, Saudi Arabia, between October 1, 2010, and March 31, 2011. RESULT: Six patients (10%) were subsequently excluded because of the treatment for latent TB (5 patients) or prior treatment for TB (1 patient). The follow-up period was 6 months for 53 patients (98.15%) and 3 months for 1 patient (1.85%). During follow-up, none of the patients received the purified protein derivative skin test while radiological studies were performed for 30 patients (55.55%). 53 patients (98.15%) had no symptoms suggestive of TB upon follow-up, and no patient experienced a TB flare-up. CONCLUSION: Rituximab can be considered a first line of therapy for the management of rheumatological diseases in the presence of the risk of TB reactivation, especially in endemic areas with a high prevalence and incidence of TB.
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spelling pubmed-54264142017-05-24 Risk of tuberculosis reactivation with rituximab therapy Alkadi, Amjad Alduaiji, Najla Alrehaily, Ali Int J Health Sci (Qassim) Original Article BACKGROUND: Tuberculosis (TB) is one of the world’s deadliest diseases, and one-third of the world’s population is infected with it. The link between antitumor necrosis factor therapy and reactivation of latent TB is well recognized. However, only limited studies have evaluated the risk of TB with rituximab, a B-cell-targeting therapeutic agent used recently for rheumatological diseases, primarily rheumatoid arthritis. Moreover, no studies have assessed this risk in TB endemic regions with a high incidence and prevalence of TB (e.g., Saudi Arabia). OBJECTIVE: To examine the risk of acquiring TB or activating latent TB in adult patients with rheumatological disease who received rituximab therapy. METHODOLOGY: Retrospective cohort study included 60 patients at King Faisal Specialist Hospital and Research Centre, Saudi Arabia, between October 1, 2010, and March 31, 2011. RESULT: Six patients (10%) were subsequently excluded because of the treatment for latent TB (5 patients) or prior treatment for TB (1 patient). The follow-up period was 6 months for 53 patients (98.15%) and 3 months for 1 patient (1.85%). During follow-up, none of the patients received the purified protein derivative skin test while radiological studies were performed for 30 patients (55.55%). 53 patients (98.15%) had no symptoms suggestive of TB upon follow-up, and no patient experienced a TB flare-up. CONCLUSION: Rituximab can be considered a first line of therapy for the management of rheumatological diseases in the presence of the risk of TB reactivation, especially in endemic areas with a high prevalence and incidence of TB. Qassim Uninversity 2017 /pmc/articles/PMC5426414/ /pubmed/28539862 Text en Copyright: © International Journal of Health Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Alkadi, Amjad
Alduaiji, Najla
Alrehaily, Ali
Risk of tuberculosis reactivation with rituximab therapy
title Risk of tuberculosis reactivation with rituximab therapy
title_full Risk of tuberculosis reactivation with rituximab therapy
title_fullStr Risk of tuberculosis reactivation with rituximab therapy
title_full_unstemmed Risk of tuberculosis reactivation with rituximab therapy
title_short Risk of tuberculosis reactivation with rituximab therapy
title_sort risk of tuberculosis reactivation with rituximab therapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426414/
https://www.ncbi.nlm.nih.gov/pubmed/28539862
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