Abstract
Tumour necrosis factor antagonists (anti-TNFα) have become an invaluable treatment against chronic inflammatory diseases. Individuals treated with anti-TNFα have more than a fourfold increased risk of tuberculosis (TB) reactivation depending on the clinical setting and the TNF-antagonist used. All candidates for anti-TNFα treatment in Denmark should be evaluated for possible latent TB using history of exposure, chest X-ray and an interferon-γ release assay. Preventive chemotherapy is recommended for all individuals with latent TB infection before initiation of anti-TNFα as it is expected to reduce the risk of progression to active TB.
MeSH terms
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Anti-Inflammatory Agents / adverse effects*
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Anti-Inflammatory Agents / therapeutic use
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Antibodies, Monoclonal / adverse effects*
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Humans
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Immunologic Tests
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Immunosuppressive Agents / adverse effects
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Interferon-gamma / metabolism
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Latent Tuberculosis / diagnosis*
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Latent Tuberculosis / immunology
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Latent Tuberculosis / prevention & control
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Risk Factors
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Tuberculin Test
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Tuberculosis, Pulmonary / diagnosis*
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Tuberculosis, Pulmonary / immunology
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Tuberculosis, Pulmonary / prevention & control
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Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Substances
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Anti-Inflammatory Agents
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Antibodies, Monoclonal
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Immunosuppressive Agents
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Tumor Necrosis Factor-alpha
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Interferon-gamma