Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy
Psoriatic patients with latent tuberculosis infection and properly treated active tuberculosis need careful management when prescribing modern biological drugs. Although data and guidelines regarding tumour necrosis factor-α inhibitors advise caution and initiation of prophylactic therapy in patient...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2022-11-01
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| Series: | Acta Dermato-Venereologica |
| Subjects: | |
| Online Access: | https://medicaljournalssweden.se/actadv/article/view/1982 |
| _version_ | 1828303143895564288 |
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| author | Luca Mastorino Paolo Dapavo Mattia Trunfio Gianluca Avallone Marco Rubatto Andrea Calcagno Simone Ribero Pietro Quaglino |
| author_facet | Luca Mastorino Paolo Dapavo Mattia Trunfio Gianluca Avallone Marco Rubatto Andrea Calcagno Simone Ribero Pietro Quaglino |
| author_sort | Luca Mastorino |
| collection | DOAJ |
| description | Psoriatic patients with latent tuberculosis infection and properly treated active tuberculosis need careful management when prescribing modern biological drugs. Although data and guidelines regarding tumour necrosis factor-α inhibitors advise caution and initiation of prophylactic therapy in patients with latent tuberculosis infection, the same indications do not seem to find equal force for interleukin (IL)-23 and IL-17 inhibitors. In order to evaluate the risk of reactivation in patients with latent tuberculosis infection or properly treated active tuberculosis, an observational retrospective study was conducted on the population referred to our centre at Dermatologic Clinic of University of Turin, Italy. In the last 10 years at the clinic 19 psoriatic patients were found to be at risk of tuberculosis reactivation: 10 patients were QuantiFERON- TB-positive at baseline, 2 became positive during treatment, 6 reported prior tuberculous infection, and 1 was QuantiFERON-TB-negative at baseline and developed disseminated tuberculosis during treatment with anti-tumour necrosis factor-α. Overall, 10.5% of this group of patients developed active tuberculosis; however, stratifying by biologic therapy, zero cases were observed among patients treated with anti-IL-17, -23, or -12/23 over a relatively long follow-up (48.1 months) A review of the available literature following our experience confirms the increased risk of tuberculosis reactivation with tumour necrosis factor-α inhibitors. Concerning anti-IL-23 and IL-17 drugs, available data showed high safety in patients at risk of tuberculosis reactivation. Screening of patients who should be taking IL-17 and IL-23 inhibitors is recommended for public health purposes. In case of a positive result with these therapies, consulting with an infectious diseases specialist is suggested in order to weigh up the risks and benefits of prophylactic treatment.
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| first_indexed | 2024-04-13T13:48:31Z |
| format | Article |
| id | doaj.art-07916918e16f4de7b2a8bdc82a52de44 |
| institution | Directory Open Access Journal |
| issn | 0001-5555 1651-2057 |
| language | English |
| last_indexed | 2024-04-13T13:48:31Z |
| publishDate | 2022-11-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Dermato-Venereologica |
| spelling | doaj.art-07916918e16f4de7b2a8bdc82a52de442022-12-22T02:44:25ZengMedical Journals SwedenActa Dermato-Venereologica0001-55551651-20572022-11-0110210.2340/actadv.v102.1982Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern ItalyLuca Mastorino0Paolo Dapavo1Mattia Trunfio2Gianluca Avallone3Marco Rubatto4Andrea Calcagno5Simone Ribero6Pietro Quaglino7Dermatology Clinic, Department of Medical Sciences, Turin, ItalyDermatology Clinic, Department of Medical Sciences, Turin, ItalyUnit of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, ItalyDermatology Clinic, Department of Medical Sciences, Turin, ItalyDermatology Clinic, Department of Medical Sciences, Turin, ItalyUnit of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, ItalyDermatology Clinic, Department of Medical Sciences, University of Turin, via Cherasco 23, IT-10121 Turin, ItalyDermatology Clinic, Department of Medical Sciences, Turin, ItalyPsoriatic patients with latent tuberculosis infection and properly treated active tuberculosis need careful management when prescribing modern biological drugs. Although data and guidelines regarding tumour necrosis factor-α inhibitors advise caution and initiation of prophylactic therapy in patients with latent tuberculosis infection, the same indications do not seem to find equal force for interleukin (IL)-23 and IL-17 inhibitors. In order to evaluate the risk of reactivation in patients with latent tuberculosis infection or properly treated active tuberculosis, an observational retrospective study was conducted on the population referred to our centre at Dermatologic Clinic of University of Turin, Italy. In the last 10 years at the clinic 19 psoriatic patients were found to be at risk of tuberculosis reactivation: 10 patients were QuantiFERON- TB-positive at baseline, 2 became positive during treatment, 6 reported prior tuberculous infection, and 1 was QuantiFERON-TB-negative at baseline and developed disseminated tuberculosis during treatment with anti-tumour necrosis factor-α. Overall, 10.5% of this group of patients developed active tuberculosis; however, stratifying by biologic therapy, zero cases were observed among patients treated with anti-IL-17, -23, or -12/23 over a relatively long follow-up (48.1 months) A review of the available literature following our experience confirms the increased risk of tuberculosis reactivation with tumour necrosis factor-α inhibitors. Concerning anti-IL-23 and IL-17 drugs, available data showed high safety in patients at risk of tuberculosis reactivation. Screening of patients who should be taking IL-17 and IL-23 inhibitors is recommended for public health purposes. In case of a positive result with these therapies, consulting with an infectious diseases specialist is suggested in order to weigh up the risks and benefits of prophylactic treatment. https://medicaljournalssweden.se/actadv/article/view/1982tuberculosisbiologicspsoriasisinfections |
| spellingShingle | Luca Mastorino Paolo Dapavo Mattia Trunfio Gianluca Avallone Marco Rubatto Andrea Calcagno Simone Ribero Pietro Quaglino Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy Acta Dermato-Venereologica tuberculosis biologics psoriasis infections |
| title | Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy |
| title_full | Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy |
| title_fullStr | Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy |
| title_full_unstemmed | Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy |
| title_short | Risk of Reactivation of Latent Tuberculosis in Psoriasis Patients on Biologic Therapies: A Retrospective Cohort from a Tertiary Care Centre in Northern Italy |
| title_sort | risk of reactivation of latent tuberculosis in psoriasis patients on biologic therapies a retrospective cohort from a tertiary care centre in northern italy |
| topic | tuberculosis biologics psoriasis infections |
| url | https://medicaljournalssweden.se/actadv/article/view/1982 |
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