Table 3.
Clinical characteristics of 11 active TB patients during or after TNF antagonists therapy.
| Case | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Age/sex | 47/M | 50/F | 55/M | 27/M | 57/F | 20/F | 79/F | 55/M | 56/F | 33/M | 49/M |
| Underlying disease | CD | RA | CD | AS | RA | CD | RA | CD | RA | CD | RA |
| Anti-TNF agent used | Ada + INF | Ada | INF | Gol | Eta + Ada | INF | Eta + Ada | INF | Ada + Eta | INF | INF |
| Baseline chest x-ray | normal | normal | healed TB* | normal | healed TB* | normal | normal | normal | normal | normal | normal |
| Baseline TST induration, mm | 0 | 29 | 15 | 10 | 11.5 | ND | 0 | ND | 0 | 0 | 0 |
| Baseline IGRA | Positive | Positive | Positive | Positive | Positive | Negative | Negative | Negative | Negative | Negative | Negative |
| LTBI Tx | Yes | Yes | Yes | Yes | Yes | No | No | No | No | No | No |
| LTBI Tx regimen | H | H | H | H | H | — | — | — | — | — | — |
| Duration from LTBI Tx to initiation of TNF antagonist, days | 21 | 31 | 21 | 43 | 34 | — | — | — | — | — | — |
| LTBI Tx completion | completed | completed | interrupted | interrupted | completed | — | — | — | — | — | — |
| Duration of anti-TNF therapy, months | 10.7 | 13.1 | 1.4 | 1 | 23 | 20.6 | 31.5 | 3.3 | 3.3 | 1.2 | 0.7 |
| Time to TB after TNF antagonist use, months | 30.9 | 34.9 | 2.9 | 3.4 | 23.5 | 21.9 | 73.2 | 4.2 | 28.8 | 2.4 | 2 |
| Type of TB | EPTB | PTB | PTB | EPTB | PTB | PTB | PTB | PTB | PTB | EPTB | PTB |
| TB diagnosis method | culture(+) LN Bx | culture(+) sputum | culture(+) sputum | culture(+) LN Bx | culture(+) sputum | culture(+) sputum | culture(+) sputum | culture(+) sputum | culture(+) sputum | culture(+) peritoneal | culture(+) sputum |
| TB drug sensitivity | all S | INH-R | INH-R | INH-R | all S | all S | all S | all S | all S | all S | all S |
| TB Tx outcomes | completed | completed | completed | completed | death | completed | death | completed | completed | completed | completed |
*Healed TB in chest radiography was defined as apical fibronodular lesions, calcified lymph nodes, calcified solitary nodules, and pleural thickening. TB, tuberculosis; TNF, tumor necrosis factor; CD, crohn’s disease; RA, rheumatoid arthritis; AS, ankylosing spondylitis; Ada, adalimumab; INF, infliximab; Gol, golimumab; Eta, etanercept; TST, tuberculin skin test; ND, not done; IGRA, interferon gamma release assay; LTBI Tx, latent tuberculosis infection treatment; H, isoniazid; EPTB, extrapulmonary TB; PTB, pulmonary TB; LN Bx, lymph node biopsy; all S, all sensitive; INH-R, isoniazid resistant.