Rates of latent tuberculosis infection in patients treated with TNF inhibitors for psoriasis: a retrospective chart review.

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Rates of latent tuberculosis infection in patients treated with TNF inhibitors for psoriasis: a retrospective chart review.

J Dermatolog Treat. 2018 Feb 19;:1-17

Authors: Lee EB, Amin M, Man J, Egeberg A, Wu JJ

Abstract
Background Although tuberculosis screening guidelines for psoriasis patients on TNF inhibitors exist, few studies have reported the prevalence of latent tuberculosis infection (LTBI) and conversion rates in this population. Objective To determine the incidence of LTBI and active tuberculosis in patients with psoriasis receiving TNF inhibitor therapy. Methods A total of 138 patients were included in our retrospective study of patients treated from September 2004 to September 2017. Tuberculin skin test was considered positive with an induration of greater than 5 mm. History of Bacillus Calmette-Guérin vaccination, follow-up tests, and prophylaxis were recorded. Results Among 99 biologic-naïve patients, 14 had LTBI before starting biologic therapy and 5 developed LTBI during TNF inhibitor therapy. One biologic-naïve patient developed LTBI, then active tuberculosis. Among 39 non-biologic-naïve patients, 3 had LTBI before starting any biologic therapy, and one developed LTBI during treatment. Limitations Limitations include small sample size and limited information documented in the medical chart. Conclusion LTBI appears to be prevalent among psoriasis patients. Screening for LTBI in patients on biologics may reduce risk of active tuberculosis, however current methods may not be fully effective. Clinicians may need to use other tools including risk factor assessment to fully evaluate risk.

PMID: 29455561 [PubMed - as supplied by publisher]

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