Infliximab‐induced tuberculosis in patients with UC: Experience from India—a country with high prevalence of tuberculosis. Issue 6 (June 2017)

• Record Type: Journal Article
• Authors: Puri, Amarender S; Desai, Devendra; Sood, Ajit; Sachdeva, Sanjeev
• Is Part Of: Journal of gastroenterology and hepatology. Volume 32:Issue 6(2017)
• Page Start: 1191
• Page End: 1194
• Publication Date: 2017-06
• Subjects: biological therapy -- inflammatory bowel disease -- tuberculosis -- ulcerative colitis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.13669
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: Tuberculosis (TB) is a well‐recognized iatrogenic adverse event following administration of biologic therapy given for a variety of clinical indications. There is paucity of data on the development of TB following the use of biologics from countries with a high prevalence of TB. The aim of this study was to determine the risk of development of TB following biological therapy in a country, which is highly endemic for TB. Methods: The article retrospectively analyse data from three referral inflammatory bowel disease centers to evaluate the risk of development of TB following biological therapy for patients with ulcerative colitis. Results: Of the 79 patients with ulcerative colitis treated with infliximab, seven (8.8%) developed TB at a median interval of 8 weeks after the first exposure despite screening for latent TB. Three of the seven (42%) patients developed disseminated disease, whereas pulmonary disease was documented in four patients (57%). All patients were successfully treated with anti‐tuberculous drugs for a period of 6–13 months. In contrast to data from the West, none of the patients in our study had a fatal outcome. None of the patients required a colectomy after a median follow up of 2 years following cessation of the infliximab therapy. Conclusions: These data suggest that despite the significantly higher prevalence, the outcome of TB after infliximab therapy is quite sanguine in the Indian subcontinent.