The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy

BACKGROUND: Adalimumab is a fully humanized monoclonal antibody inhibitor of tumor necrosis factor-a used to treat various autoimmune disorders. Adalimumab poses a risk for tuberculosis (TB) infection, especially in countries where TB is endemic. OBJECTIVE: Determine the rate of TB infection after a...

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Autores principales:	Abdullah Al-Sohaim, Abdullah Saleh Bawazir, Turki Al-Turki, Eiman Omar Alsafi, Abdullah Al-Roqy, Layla Layqah, Salim Alawi Baharoone
Formato:	article
Lenguaje:	EN
Publicado:	King Faisal Specialist Hospital and Research Centre 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/509a4578978a4742b75b0e1ee2ff05a3
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spelling	oai:doaj.org-article:509a4578978a4742b75b0e1ee2ff05a32021-12-01T12:57:42ZThe risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy10.5144/0256-4947.2021.2850975-44660256-4947https://doaj.org/article/509a4578978a4742b75b0e1ee2ff05a32021-09-01T00:00:00Zhttp://www.annsaudimed.net/doi/10.5144/0256-4947.2021.285https://doaj.org/toc/0256-4947https://doaj.org/toc/0975-4466BACKGROUND: Adalimumab is a fully humanized monoclonal antibody inhibitor of tumor necrosis factor-a used to treat various autoimmune disorders. Adalimumab poses a risk for tuberculosis (TB) infection, especially in countries where TB is endemic. OBJECTIVE: Determine the rate of TB infection after adalimumab therapy in Saudi Arabia. DESIGN: Medical record review. SETTINGS: Tertiary care center in Riyadh. PATIENTS AND METHODS: Demographic and clinical data were retrieved from the electronic healthcare records of all patients who received adalimumab treatment from 2015 to 2019. MAIN OUTCOME MEASURES: Occurrence of TB after adalimumab therapy. SAMPLE SIZE: 410 patients (median ([QR] age, 37 [28], range 4–81 years), 40% males RESULTS: Rheumatoid arthritis was the most frequent indication (n=153, 37%). The patients were followed for a mean of 36 (8.9) months. No case of TB infection or reactivation was observed. An inter-feron-gamma release assay (IGRA) was requested in 353/391 (90.3%) patients, prior to initiating therapy. The IGRA was positive in 26 cases (6.6%). The IGRA-positive patients received isoniazid prophylactically. Bacterial infectious complications of adalimumab therapy occurred in 12 (2.9%) patients. Urinary tract infection was the most frequent complication (culture requested in 48 patients, positive in 8). CONCLUSION: Adalimumab treatment was not associated with a risk of TB disease or TB reactivation in our cohort over the follow-up observation period. No TB reactivation occurred with adalimumab therapy when TB prophylaxis was used. The positive IGRA rate in patients on adalimumab treatment was low (7%). LIMITATIONS: Single center and one geographical area in Saudi Arabia. CONFLICT OF INTEREST: None.Abdullah Al-SohaimAbdullah Saleh BawazirTurki Al-TurkiEiman Omar AlsafiAbdullah Al-RoqyLayla LayqahSalim Alawi BaharooneKing Faisal Specialist Hospital and Research CentrearticleMedicineRENAnnals of Saudi Medicine, Vol 41, Iss 5, Pp 285-292 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Abdullah Al-Sohaim Abdullah Saleh Bawazir Turki Al-Turki Eiman Omar Alsafi Abdullah Al-Roqy Layla Layqah Salim Alawi Baharoone The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy
description	BACKGROUND: Adalimumab is a fully humanized monoclonal antibody inhibitor of tumor necrosis factor-a used to treat various autoimmune disorders. Adalimumab poses a risk for tuberculosis (TB) infection, especially in countries where TB is endemic. OBJECTIVE: Determine the rate of TB infection after adalimumab therapy in Saudi Arabia. DESIGN: Medical record review. SETTINGS: Tertiary care center in Riyadh. PATIENTS AND METHODS: Demographic and clinical data were retrieved from the electronic healthcare records of all patients who received adalimumab treatment from 2015 to 2019. MAIN OUTCOME MEASURES: Occurrence of TB after adalimumab therapy. SAMPLE SIZE: 410 patients (median ([QR] age, 37 [28], range 4–81 years), 40% males RESULTS: Rheumatoid arthritis was the most frequent indication (n=153, 37%). The patients were followed for a mean of 36 (8.9) months. No case of TB infection or reactivation was observed. An inter-feron-gamma release assay (IGRA) was requested in 353/391 (90.3%) patients, prior to initiating therapy. The IGRA was positive in 26 cases (6.6%). The IGRA-positive patients received isoniazid prophylactically. Bacterial infectious complications of adalimumab therapy occurred in 12 (2.9%) patients. Urinary tract infection was the most frequent complication (culture requested in 48 patients, positive in 8). CONCLUSION: Adalimumab treatment was not associated with a risk of TB disease or TB reactivation in our cohort over the follow-up observation period. No TB reactivation occurred with adalimumab therapy when TB prophylaxis was used. The positive IGRA rate in patients on adalimumab treatment was low (7%). LIMITATIONS: Single center and one geographical area in Saudi Arabia. CONFLICT OF INTEREST: None.
format	article
author	Abdullah Al-Sohaim Abdullah Saleh Bawazir Turki Al-Turki Eiman Omar Alsafi Abdullah Al-Roqy Layla Layqah Salim Alawi Baharoone
author_facet	Abdullah Al-Sohaim Abdullah Saleh Bawazir Turki Al-Turki Eiman Omar Alsafi Abdullah Al-Roqy Layla Layqah Salim Alawi Baharoone
author_sort	Abdullah Al-Sohaim
title	The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy
title_short	The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy
title_full	The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy
title_fullStr	The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy
title_full_unstemmed	The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy
title_sort	risk of tuberculosis infection in 410 saudipatients receiving adalimumab therapy
publisher	King Faisal Specialist Hospital and Research Centre
publishDate	2021
url	https://doaj.org/article/509a4578978a4742b75b0e1ee2ff05a3
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The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy

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