Tuberculosis in Juvenile Idiopathic arthritis under Anti-TNF therapy

Tuberculosis (TB) is still a prevalent disease, one third of the population is infected by mycobacterium tuberculosis (MT).Treatment with anti TNF therapies appears to increase the risk for developing TB

Aim

To study the occurrence of latent TB (LTB) or tuberculosis disease (TBD) in children with JIA under anti TNF therapy.

Methods

Clinical records from pts with JIA ( ILAR´01) under anti-TNF therapy were reviewed, focusing on TB screening prior to biologicals , PPD conversion or TBD diagnosiss.LTB was considered as a PPD (TST) positive (≥ 5 mm), in the abscense of radiological manifestations of TB.

Results

105 JIA pts received one or more anti TNF drugs during the observation. Four of them developed LTB and 3 others TBD.

Table

No extrapulmonar TB or miliary forms were observed. All patients were PPD negative prior to biological agents

Conclusions

No significative difference was found between specific anti TNF and the occurrence of LTB or TBD. In 4 pts, the infectious event occurred after 2 ys of exposure and in two earlier as described in the literature. This data highlights the importance of TB surveillance prior to and during anti-TNF therapy.