Özet:

Background: Tumor necrosis factor-α TNF-α is a proinflammatory cytokine, which plays an important role in the pathogenesis of several inflammatory diseases such as ankylosing spondylitis AS , rheumatoid arthritis RA and psoriatic arthritis PsA . Anti-TNF-α therapy is now widely used for treatment of inflammatory diseases. An increased incidence of tuberculosis in patients under anti-TNF-α therapy has been reported. The aim of this study was to investigate the prevalence of latent tuberculosis in patients treated with an anti-TNF-α agent. Methods: Eighty three patients under anti-TNF-α treatment referring to the Rheumatology outpatient clinic enrolled in the study. Tuberculin skin test PPD and chest x-ray are performed. An induration of 5 mm or more is defined as latent tuberculosis. Patients with latent tuberculosis are treated with isoniazid INH 300 mg/day during 9 months. Results: Mean age of the 83 patients was 37.59±10.80 years; the average duration of illness was 9.82±7.08 years. The primary disease was AS n=62 , RA n=16 , and PsA n=5 . The patients were treated with different anti-TNF-α agents etanercept n=30, adalimumab n=30, infliximab n=21, and golimumab n=2 . PPD induration of 5 mm or more was measured in 63 76% of 83 patients. INH prophylaxis was started in 76 of the patients including 13 patients with PPD induration < 5mm due to increased risk of tuberculosis family history, working as a health professional, history of infected with mycobacterium tuberculosis . The number of male patients 76% with PPD induration 5 mm is significantly higher than the number of female patients ≥ 24% with PPD induration 5 mm p=0.026 . The number of patients with AS in patients with PPD ≥ induration 5 mm n=51, 81% is significantly higher than the number of patients with AS in patients with ≥ PPD induration

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