Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents

• DOI: 10.3748/wjg.v21.i11.3308
• Publication Date: 2017-09-17T23:09:13Z
• Authors: Eun Soo Kim; Geun Am Song; Kwang Bum Cho; Kyung Sik Park; Kyeong Ok Kim; Byung Ik Jang; Eun Young Kim; Seong Woo Jeon; Hyun Seok Lee; Chang Heon Yang; Yong Kook Lee; Dong Wook Lee; Sung Kook Kim; Tae Oh Kim; Jonghun Lee; Hyung Wook Kim; Sam Ryong Jee; Seun Ja Park; Hyun Jin Kim
• Keywords: Adult; Male; Anti-Inflammatory Agents; 610; Opportunistic Infections; Tertiary Care Centers; Immunocompromised Host; 03 medical and health sciences; 0302 clinical medicine; Crohn Disease; Risk Factors; 616; Republic of Korea; Humans; Tuberculosis; Retrospective Studies; Tumor Necrosis Factor-alpha; Incidence; Adalimumab; Middle Aged; Infliximab; 3. Good health; Treatment Outcome; Colitis, Ulcerative; Female

AIM:To evaluate the incidence and risk factors of Korean tuberculosis (TB) infection in patients with inflammatory bowel disease (IBD) undergoing anti-TNF treatment. METHODS:The data IBD treated anti-TNFs 13 tertiary referral hospitals located southeastern region Korea were collected retrospectively.They failed to show response or intolerant conventional treatments, including steroids immunomodulators.Screening measures for latent TB (LTBI) Retrospective Study ORIGINAL ARTICLEactive after treatment identified. RESULTS:Overall, 376 agents recruited (male 255, mean age therapy 32.5 ± 13.0 years); 277 had Crohn's disease, 99 ulcerative colitis, 294 used infliximab, 82 adalimumab.Before treatment, screening tests LTBI an interferon gamma release assay a tuberculin skin test performed 82.2% patients.Thirty (8%) LTBI.Sixteen cases active one TB-related mortality occurred during 801 personyears (PY) follow-up (1997.4cases per 100000 PY) treatment.LTBI (OR = 5.76, 95%CI:1.57-21.20,P 0.008) WBC count < 5000 mm 3 4.5, 95%CI: 1.51-13.44,P 0.007) identified as independently associated factors. CONCLUSION:Anti-TNFs significantly increase IBD.The considerable burden marked immunosuppression might be attributed this risk.