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Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs
Chronic rheumatic diseases entail the use of biologics in children. Immunosuppressive effects of drug therapy put children at risk of various infections including tuberculosis (TB). Even though TB is a major concern among individuals on biological DMARDs, the incidence and distribution among childre...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Mediterranean Journal of Rheumatology (MJR)
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802205/ https://www.ncbi.nlm.nih.gov/pubmed/35128322 http://dx.doi.org/10.31138/mjr.32.4.290 |
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author | Kavadichanda, Chengappa Adarsh, MB Ajmani, Sajal Maccora, Ilaria Balan, S Ramanan, AV Agarwal, Vikas Gupta, Latika |
author_facet | Kavadichanda, Chengappa Adarsh, MB Ajmani, Sajal Maccora, Ilaria Balan, S Ramanan, AV Agarwal, Vikas Gupta, Latika |
author_sort | Kavadichanda, Chengappa |
collection | PubMed |
description | Chronic rheumatic diseases entail the use of biologics in children. Immunosuppressive effects of drug therapy put children at risk of various infections including tuberculosis (TB). Even though TB is a major concern among individuals on biological DMARDs, the incidence and distribution among children on these drugs is not known. Hence, we performed a literature search to ascertain the prevalence of tuberculosis amongst children with rheumatic disorders treated with biological agents. Articles available on MEDLINE and SCOPUS published on or after January 1, 2010 to 1 October 2019 were reviewed and collated. We found that published data on TB infections in children with rheumatic disorders on biologics is scant even from regions with highest TB burden. Tuberculosis was reported on occasion (0–5 cases per country) in the developed world with most reports being from Turkey. While most of the retrospective studies suggest that TB risk is minimal in the paediatric rheumatology patients, prospective studies suffer from a short observation period. Most registries focus on response to therapy rather than complications. In this review we have then discussed about the variation in screening strategies for latent TB and the role of bacille Calmette-Guerin (BCG) vaccination. Based on the dearth of data and inconsistency in data collection, we propose a way forward in the form of establishing well-designed long-term prospective national registries from countries with high background prevalence of TB with focus not only on treatment efficacy but also on adverse events and infections. |
format | Online Article Text |
id | pubmed-8802205 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Mediterranean Journal of Rheumatology (MJR) |
record_format | MEDLINE/PubMed |
spelling | pubmed-88022052022-02-04 Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs Kavadichanda, Chengappa Adarsh, MB Ajmani, Sajal Maccora, Ilaria Balan, S Ramanan, AV Agarwal, Vikas Gupta, Latika Mediterr J Rheumatol Narrative Review Chronic rheumatic diseases entail the use of biologics in children. Immunosuppressive effects of drug therapy put children at risk of various infections including tuberculosis (TB). Even though TB is a major concern among individuals on biological DMARDs, the incidence and distribution among children on these drugs is not known. Hence, we performed a literature search to ascertain the prevalence of tuberculosis amongst children with rheumatic disorders treated with biological agents. Articles available on MEDLINE and SCOPUS published on or after January 1, 2010 to 1 October 2019 were reviewed and collated. We found that published data on TB infections in children with rheumatic disorders on biologics is scant even from regions with highest TB burden. Tuberculosis was reported on occasion (0–5 cases per country) in the developed world with most reports being from Turkey. While most of the retrospective studies suggest that TB risk is minimal in the paediatric rheumatology patients, prospective studies suffer from a short observation period. Most registries focus on response to therapy rather than complications. In this review we have then discussed about the variation in screening strategies for latent TB and the role of bacille Calmette-Guerin (BCG) vaccination. Based on the dearth of data and inconsistency in data collection, we propose a way forward in the form of establishing well-designed long-term prospective national registries from countries with high background prevalence of TB with focus not only on treatment efficacy but also on adverse events and infections. The Mediterranean Journal of Rheumatology (MJR) 2021-12-27 /pmc/articles/PMC8802205/ /pubmed/35128322 http://dx.doi.org/10.31138/mjr.32.4.290 Text en © 2021 The Mediterranean Journal of Rheumatology (MJR) https://creativecommons.org/licenses/by/4.0/This work is licensed under and Creative Commons Attribution-NonCommercial 4.0 International License. |
spellingShingle | Narrative Review Kavadichanda, Chengappa Adarsh, MB Ajmani, Sajal Maccora, Ilaria Balan, S Ramanan, AV Agarwal, Vikas Gupta, Latika Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs |
title | Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs |
title_full | Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs |
title_fullStr | Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs |
title_full_unstemmed | Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs |
title_short | Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs |
title_sort | tuberculosis in children with rheumatic diseases treated with biologic disease-modifying anti-rheumatic drugs |
topic | Narrative Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802205/ https://www.ncbi.nlm.nih.gov/pubmed/35128322 http://dx.doi.org/10.31138/mjr.32.4.290 |
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