Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy
Tumor necrosis factor-alpha inhibitors (TNFIs) increase the risk of tuberculosis (TB). The aim of this study was to evaluate pediatric patients who are under TNFIs regarding the emergence of TB, and to determine the effectiveness of screening methods. This was a retrospective observational st...
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| Format: | Article |
| Language: | English |
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Hacettepe University Institute of Child Health
2017-10-01
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| Series: | The Turkish Journal of Pediatrics |
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| Online Access: | https://turkjpediatr.org/article/view/1023 |
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| author | Manolya Acar Murat Sütçü Hacer Aktürk Selda Hançerli-Torun Oğuz Bülent Erol Nuran Salman Ayper Somer |
| author_facet | Manolya Acar Murat Sütçü Hacer Aktürk Selda Hançerli-Torun Oğuz Bülent Erol Nuran Salman Ayper Somer |
| author_sort | Manolya Acar |
| collection | DOAJ |
| description |
Tumor necrosis factor-alpha inhibitors (TNFIs) increase the risk of tuberculosis (TB). The aim of this study was to evaluate pediatric patients who are under TNFIs regarding the emergence of TB, and to determine the effectiveness of screening methods. This was a retrospective observational study of 73 patients receiving TNFIs therapy for at least 6 months duration between January 2011 and January 2016. Detailed demographic and clinical data were gathered from patients` files. Seventy-three patients (female n=41, 56.2%) with a median age of 129 (38-215) months were enrolled. Median follow-up period was 18 (6-60) months. Median duration of primary illness prior to TNFI therapy was 24 (2-184) months. Sixteen patients (21.9%) with latent tuberculosis infection (LTBI) were given isoniazid (INH) prior to TNFI therapy. TNFIs were adalimumab (n=39, 53.5%), infliximab (n=22, 30.1%) and etanercept (n=12, 16.4%). During follow-up, 16 patients (21.9%) were started on INH treatment. Median time of starting INH was 20 (4-42) months. One patient (3.1%) who received INH had elevated liver transaminases. One patient (1.3%) developed active TB during follow-up. In conclusion, patients who are candidates for TNFI treatment should be screened for TB before and during therapy.
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| format | Article |
| id | doaj-art-fe03dbcbd4f5474bb699102091a9d821 |
| institution | DOAJ |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2017-10-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-fe03dbcbd4f5474bb699102091a9d8212025-08-20T03:16:22ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212017-10-0159510.24953/turkjped.2017.05.001Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapyManolya Acar0Murat Sütçü1Hacer Aktürk2Selda Hançerli-Torun3Oğuz Bülent Erol4Nuran Salman5Ayper Somer6Division of Infectious Diseases, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey.Division of Infectious Diseases, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey.Division of Infectious Diseases, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey.Division of Infectious Diseases, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey.Department of Pediatric Radiology, Private Clinic, Istanbul, Turkey.Division of Infectious Diseases, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey.Division of Infectious Diseases, Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, Istanbul, Turkey. Tumor necrosis factor-alpha inhibitors (TNFIs) increase the risk of tuberculosis (TB). The aim of this study was to evaluate pediatric patients who are under TNFIs regarding the emergence of TB, and to determine the effectiveness of screening methods. This was a retrospective observational study of 73 patients receiving TNFIs therapy for at least 6 months duration between January 2011 and January 2016. Detailed demographic and clinical data were gathered from patients` files. Seventy-three patients (female n=41, 56.2%) with a median age of 129 (38-215) months were enrolled. Median follow-up period was 18 (6-60) months. Median duration of primary illness prior to TNFI therapy was 24 (2-184) months. Sixteen patients (21.9%) with latent tuberculosis infection (LTBI) were given isoniazid (INH) prior to TNFI therapy. TNFIs were adalimumab (n=39, 53.5%), infliximab (n=22, 30.1%) and etanercept (n=12, 16.4%). During follow-up, 16 patients (21.9%) were started on INH treatment. Median time of starting INH was 20 (4-42) months. One patient (3.1%) who received INH had elevated liver transaminases. One patient (1.3%) developed active TB during follow-up. In conclusion, patients who are candidates for TNFI treatment should be screened for TB before and during therapy. https://turkjpediatr.org/article/view/1023TNF-alpha inhibitorscreeningtuberculosis |
| spellingShingle | Manolya Acar Murat Sütçü Hacer Aktürk Selda Hançerli-Torun Oğuz Bülent Erol Nuran Salman Ayper Somer Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy The Turkish Journal of Pediatrics TNF-alpha inhibitor screening tuberculosis |
| title | Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy |
| title_full | Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy |
| title_fullStr | Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy |
| title_full_unstemmed | Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy |
| title_short | Tuberculosis screening in pediatric patients receiving TNF-alpha inhibitor therapy |
| title_sort | tuberculosis screening in pediatric patients receiving tnf alpha inhibitor therapy |
| topic | TNF-alpha inhibitor screening tuberculosis |
| url | https://turkjpediatr.org/article/view/1023 |
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