Abstract:

Objective To investigate the prevention treatment for tuberculosis in patients treated with tumor necrosis factor (TNF) antagonists in some areas of China. Methods A total of 981 rheumatoid arthritis (RA) or ankylosing spondylitis (AS) patients treated with etanercept or infliximab from 13 large general hospitals in eastern, central and western China from March 2014 to February 2016 were selected. The clinical data of gender, age, hormone and immunosuppressant use, underlying disease, tuberculosis history, latent tuberculosis infection (LTBI) screening, chest X-ray or CT scan results, prevention treatment of tuberculosis were collected,. The proportion of LTBI and inactive tuberculosis screening, the proportion of prevention treatment for tuberculosis and the treatment regimens in RA or AS patients with TNF antagonist were analyzed. Results Of the 981 subjects, 779 (79.4%) were treated with etanercept and 202 (20.6%) with infliximab. Only 25.7% (252/981) subjects were screened for LTBI, and the positive rate was 18.3% (46/252). And 2.8% (27/981) of the subjects were diagnosed as inactive tuberculosis, of which 19 cases had a history of tuberculosis. Of the 712 patients (72.6%) who underwent chest X-ray and/or CT scan, 13 (1.8%) were reported inactive pulmonary tuberculosis. A total of 15 subjects received TB prevention treatment; 6 (13.0%, 6/46) of the patients complicated with LTBI received tuberculosis preventive treatment; none of the patients diagnosed as inactive tuberculosis received tuberculosis prevention treatment. Among the patients who received tuberculosis prevention treatment, 9 cases (60.0%, 9/15) were treated with isoniazid monotherapy for 1-18 months. Conclusion In some areas of China, the proportion of LTBI screening in RA or AS patients treated with TNF antagonists was low, the proportion of tuberculosis prevention treatment was low, the selection criteria of prevention objects were different, and the prevention scheme was not standardized.

Key words: Tumor necrosis factors, Antistatic agents, Arthritis,rheumatoid, Spondylitis,ankylosing, Tuberculosis, Protective agents