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Indian J Dermatol Venereol Leprol. 2019 Nov 12. doi: 10.4103/ijdvl.IJDVL_791_18. [Epub ahead of print]

Risk of tuberculosis with anti-tumor necrosis factor-alpha therapy in patients with psoriasis and psoriatic arthritis in Indian population.

Author information

1
Division of Rheumatology, Allergy and Clinical Immunology, Davis, CA, USA.
2
Department of Dermatology, KPC Medical College, Kolkata, West Bengal, India.
3
Department of Dermatology, School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea; Department of Dermatology, School of Medicine, University of California, Davis, CA, USA.
4
VA Medical Center Sacramento, Mather, CA, USA.
5
Department of Critical Care Medicine, IPGME and R, Kolkata, West Bengal, India.
6
Division of Rheumatology, Allergy and Clinical Immunology; Department of Dermatology, School of Medicine, University of California, Davis; VA Medical Center Sacramento, Mather, CA, USA.

Abstract

Anti-tumor necrosis factor-alpha (TNF-α) immunotherapy has revolutionized the treatment of inflammatory diseases, such as psoriasis and psoriatic arthritis. However, a major concern is that patients receiving this therapy have an increased risk of infection, particularly of reactivation of latent tuberculosis (TB). There were an estimated 10.4 million new cases of tuberculosis in 2016, worldwide, and India has one of the largest TB case burden with an estimated incidence of 2.79 million cases of TB in the same year. Anti-TNF agents like etanercept and infliximab are available in India approved for psoriasis and psoriatic arthritis. But long-term use of these agents possesses a risk of reactivation of latent TB. In this review article, we assessed the risk of TB with anti-TNF therapy especially in patients with psoriasis and psoriatic arthritis in India. At the end of the article, we have also suggested a recommendation for screening of latent tuberculosis and its management, before starting anti-TNF-α therapy.

KEYWORDS:

Anti-tumor necrosis factor agents; latent tuberculosis; psoriasis; psoriatic arthritis

PMID:
31719235
DOI:
10.4103/ijdvl.IJDVL_791_18

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