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- Clinical features of active tuberculosis that developed during anti-tumor necrosis factor therapy in patients with inflammatory bowel disease
- Jang Wook Lee, Chang Hwan Choi, Ji Hoon Park, Jeong Wook Kim, Sang Bum Kang, Ja Seol Koo, Young-Ho Kim, You Sun Kim, Young Eun Joo, Sae Kyung Chang
- Intest Res 2016;14(2):146-151. Published online April 27, 2016
- DOI: https://doi.org/10.5217/ir.2016.14.2.146
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Abstract
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ePub <b>Background/Aims</b><br/> Anti-tumor necrosis factor (TNF) therapy for active ulcerative colitis (UC) and Crohn's disease (CD) is associated with increased risks of tuberculosis (TB) infection. We analyzed the incidence and clinical features of Korean patients with inflammatory bowel disease (IBD) who developed active TB during anti-TNF therapy.
Methods Ten cases of active TB developed in patients treated with infliximab (n=592) or adalimumab (n=229) for UC (n=160) or CD (n=661) were reviewed. We analyzed demographics, interval between start of anti-TNF therapy and active TB development, tests for latent TB infection (LTBI), concomitant medications, and the details of diagnosis and treatments for TB.
Results The incidence of active TB was 1.2% (10/821): 1.5% (9/592) and 0.4% (1/229) in patients receiving infliximab and adalimumab, respectively. The median time to the development of active TB after initiation of anti-TNF therapy was three months (range: 2–36). Three patients had past histories of treatment for TB. Positive findings in a TB skin test (TST) and/or interferon gamma releasing assay (IGRA) were observed in three patients, and two of them received anti-TB prophylaxis. Two patients were negative by both TST and IGRA. The most common site of active TB was the lungs, and the active TB was cured in all patients.
Conclusions Active TB can develop during anti-TNF therapy in IBD patients without LTBI, and even in those with histories of TB treatment or LTBI prophylaxis. Physicians should be aware of the potential for TB development during anti-TNF therapy, especially in countries with a high prevalence of TB.
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Citations
Citations to this article as recorded by
- (Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
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O.V. Knyazev, O.B. Schukina, A.V. Kagramanova, A.A. Lishchinskaya, I.A. Li, E.A. Sabelnikova, B.A. Nanaeva, M.Yu. Timanovskaya, T.A. Kosacheva, N.A. Fadeeva, K.A. Nikolskaya, E.Yu. Zhulina, N.V. Kamzarakova, A.I. Parfenov
Dokazatel'naya gastroenterologiya.2023; 12(3): 29. CrossRef - Five-Year Efficacy and Safety of Ustekinumab Treatment in Crohn’s Disease: The IM-UNITI Trial
William J. Sandborn, Rory Rebuck, Yuhua Wang, Bin Zou, Omoniyi J. Adedokun, Christopher Gasink, Bruce E. Sands, Stephen B. Hanauer, Stephan Targan, Subrata Ghosh, Willem J.S. de Villiers, Jean-Frederic Colombel, Brian G. Feagan, John P. Lynch
Clinical Gastroenterology and Hepatology.2022; 20(3): 578. CrossRef - Monitoring frequency of interferon gamma release assay for tuberculosis surveillance following infliximab therapy in patients with Crohn's disease
Qin Yu Yang, Yi Juan Liu, Ye Xu, Lin Zhang, Cheng Dang Wang
Journal of Digestive Diseases.2021; 22(8): 473. CrossRef - Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy
Jihye Kim, Jong Pil Im, Jae-Joon Yim, Chang Kyun Lee, Dong Il Park, Chang Soo Eun, Sung-Ae Jung, Jeong Eun Shin, Kang-Moon Lee, Jae Hee Cheon
The Korean Journal of Gastroenterology.2020; 75(1): 29. CrossRef - Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
Hosim Soh, Jaeyoung Chun, Kyungdo Han, Seona Park, Gukhwan Choi, Jihye Kim, Jooyoung Lee, Jong Pil Im, Joo Sung Kim
Gut and Liver.2019; 13(3): 333. CrossRef - Discontinuation of Biological Treatments in Inflammatory Bowel Disease
Shomron Ben-Horin, Ren Mao, Yun Qiu, Minhu Chen
Journal of Clinical Gastroenterology.2018; 52(1): 6. CrossRef - Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasu
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The Korean Journal of Internal Medicine.2018; 33(1): 20. CrossRef - Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease
Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang
Intestinal Research.2018; 16(3): 400. CrossRef - Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti‐tumor necrosis factor treatment. Part 2: Management
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin‐Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasu
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Jong Pil Im, Byong Duk Ye, You Sun Kim, Joo Sung Kim
The Korean Journal of Internal Medicine.2018; 33(1): 28. CrossRef - Incidence of Active Tuberculosis within One Year after Tumor Necrosis Factor Inhibitor Treatment according to Latent Tuberculosis Infection Status in Patients with Inflammatory Bowel Disease
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Journal of Korean Medical Science.2018;[Epub] CrossRef - CD8 + CD28 + /CD8 + CD28 − T cell equilibrium can predict the active stage for patients with inflammatory bowel disease
Shi-xue Dai, Hong-xiang Gu, Qian-yi Lin, Shao-zhuo Huang, Tiao-si Xing, Qing-fang Zhang, Gang Wu, Min-hua Chen, Wan-er Tan, Hong-jian Jian, Zhong-wen Zheng, Tao Zhong, Min-hai Zhang, Xing-fang Cheng, Peng Huang, Guang-jie Liao, Wei-hong Sha
Clinics and Research in Hepatology and Gastroenterology.2017; 41(6): 693. CrossRef
- (Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
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- Diabetes Mellitus and the Risk of Colorectal Adenoma
- Sang-Jung Kim, Chang Hwan Choi, Hong Ju Moon, Jang Sik Mun, Hyun Woong Lee, Hyung Joon Kim, Jae Hyuk Do, Sae Kyung Chang
- Intest Res 2008;6(1):50-55. Published online June 30, 2008
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Abstract
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- Background/Aims
Diabetes mellitus (DM) is associated with an increased incidence of colon cancer. However, the relationship between DM and colorectal adenoma is not definite. In this study, we sought to determine the association between DM and the prevalence of colorectal adenoma. Methods: We enrolled 606 patients with DM and 606 asymptomatic adults who underwent colonoscopy for routine health evaluations from June 2003 to June 2007. The frequency and characteristics of the colorectal adenomas were analyzed and compared between the two groups. Results: The sex ratio and mean age were 1.67：1 (M：F) and 58.1±10.6 years, respectively, in patients with DM, and 1.68:1 and 57.6±8.9 years, respectively, in patients without DM, and these values were similar. The frequency of colorectal adenoma was 33.2% for the patients with DM and 32.3% for the patients without DM. The frequency, location, number, size and histopathologic findings of the colorectal adenomas were not different between the two groups. Among the patients with DM, the frequency of colorectal adenoma was 35.7% in the patients treated with oral hypoglycemic agents and 31.4% in the patients treated with insulin. Also, the other characteristics of the colorectal adenomas were not different according to the treatment method. Conclusions: The frequency and characteristics of colorectal adenomas were not different between the patients with and without DM. (Intest Res 2008;6:50-55)
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