Series "update on tuberculosis" edited by C. Lange, M. Raviglione, W.W. Yew and G.B. Migliori number 2 in this series: The risk of tuberculosis related to tumour necrosis factor antagonist therapies: A TBNET consensus statement

I. Solovic, M. Sester, J. J. Gomez-Reino, H. L. Rieder, S. Ehlers, H. J. Milburn, B. Kampmann, B. Hellmich, R. Groves, S. Schreiber, R. S. Wallis, G. Sotgiu, E. H. Schölvinck, D. Goletti, J. P. Zellweger, R. Diel, L. Carmona, F. Bartalesi, P. Ravn, A. BossinkR. Duarte, C. Erkens, J. Clark, G. B. Migliori, C. Lange

Research output: Contribution to journalArticlepeer-review

Abstract

Anti-tumour necrosis factor (TNF) monoclonal antibodies or soluble TNF receptors have become an invaluable treatment against chronic inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel disease and psoriasis. Individuals who are treated with TNF antagonists are at an increased risk of reactivating latent infections, especially tuberculosis (TB). Following TNF antagonist therapy, the relative risk for TB is increased up to 25 times, depending on the clinical setting and the TNF antagonist used. Interferon-c release assays or, as an alternative in individuals without a history of bacille Calmette-Guérin vaccination, tuberculin skin testing is recommended to screen all adult candidates for TNF antagonist treatment for the presence of latent infection with Mycobacterium tuberculosis. Moreover, paediatric practice suggests concomitant use of both the tuberculin skin test and an interferon-γ release assay, as there are insufficient data in children to recommend one test over the other. Consequently, targeted preventive chemotherapy is highly recommended for all individuals with persistent M. tuberculosis-specific immune responses undergoing TNF antagonist therapy as it significantly reduces the risk of progression to TB. This TBNET consensus statement summarises current knowledge and expert opinions and provides evidence-based recommendations to reduce the TB risk among candidates for TNF antagonist therapy. Copyright

Original languageEnglish
Pages (from-to)1185-1206
Number of pages22
JournalEuropean Respiratory Journal
Volume36
Issue number5
DOIs
Publication statusPublished - Nov 1 2010

Keywords

  • Interferon-γ release assay
  • Tuberculin skin test
  • Tuberculosis
  • Tumour necrosis factor

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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