Management of long-term therapy with biological drugs in psoriatic patients with latent tuberculosis infection in real life setting.
Andrea ContiStefano PiasericoPaolo GisondiGiulia OdoriciGiovanna GaldoClaudia LasagniGiovanni PellacaniPublished in: Dermatologic therapy (2017)
Psoriatic patients with latent tuberculosis infection (LTBI) need a prophylaxis before starting a treatment with biological drugs. The aim of this study is to investigate the safety and efficacy of prophylaxis of LTBI in psoriatic patients receiving long-term biological drugs. The study included 56 patients (42 male and 14 female) affected by moderate-to-severe psoriasis (mean PASI: 12.8 ± 6.9 SD) treated with anti-TNF-α and/or anti IL 12, 23 and/or anti-CD11 drugs with a diagnosis of LTBI. LTBI diagnosis was based on tuberculin skin test and/or QuantiFERON TB Gold test positivity and chest X-ray suggestive, without clinical, or microbiological evidence of active disease. All patients received prophylactic therapy for 9 months with isoniazid (INH) 300 mg/day, starting 3 weeks before the beginning of biological treatment. Fifty-four patients completed prophylaxis with INH without any adverse events or intolerance; they continue the biological treatment without appearance of active tuberculosis. One patient developed tuberculosis pleurisy in course of treatment with etanercept. The infection has been treated and after a stable remission, treatment was restarted without tuberculosis reactivation. In this retrospective analysis, the prophylaxis of LTBI whit INH was effective and safe in longer follow-up period.
Keyphrases
- mycobacterium tuberculosis
- end stage renal disease
- rheumatoid arthritis
- newly diagnosed
- ejection fraction
- chronic kidney disease
- hiv aids
- stem cells
- disease activity
- magnetic resonance imaging
- magnetic resonance
- pulmonary tuberculosis
- computed tomography
- bone marrow
- human immunodeficiency virus
- systemic lupus erythematosus
- hiv infected
- soft tissue
- contrast enhanced