Restarting biologics and management of patients with flares of inflammatory rheumatic disorders or psoriasis during active tuberculosis treatment

Fabrizio Cantini, Francesca Prignano, Delia Goletti

Research output: Contribution to journalArticlepeer-review

Abstract

Our aim was to review the evidence concerning optimal timing for restarting biologics in patients with active tuberculosis (TB), and the management of relapsing rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and psoriasis during treatment for TB. Few or no indications are available for 2 important challenges for clinicians: the timing for restarting biologics in patients with TB reactivation and the management of the underlying disorder. In the absence of clear evidence, guidelines and experts suggest restarting anti-tumor necrosis factor-a (TNF-a) agents after completion of an active TB therapy course, but no indications are available on the appropriate management of patients with flares of underlying rheumatic disease or psoriasis. Among anti-TNF-a agents, etanercept is associated with the lowest risk of TB reactivation, and non-anti-TNF-a biologics and several nonbiologic drugs are associated with low/no risk of TB reactivation. Therefore, for patients with relapsing RA, PsA, AS, or psoriasis during TB treatment we propose a therapeutic schedule modulated by disease activity and individual single drug-related TB risk.

Original languageEnglish
Pages (from-to)78-82
Number of pages5
JournalJournal of Rheumatology
Volume41
Issue numberSUPPL. 91
DOIs
Publication statusPublished - 2014

Keywords

  • Active tuberculosis
  • Anti-tumor necrosis factor
  • Biologics
  • Disease activity
  • Disease flare

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy
  • Medicine(all)

Fingerprint Dive into the research topics of 'Restarting biologics and management of patients with flares of inflammatory rheumatic disorders or psoriasis during active tuberculosis treatment'. Together they form a unique fingerprint.

Cite this