Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan
Background: Active tuberculosis (TB) in patients with latent tuberculosis infection (LTBI) was associated with use of biological agents for immune-mediated inflammatory disorders (IMIDs). For decreasing active TB, isoniazid prophylaxis therapy was administered before biologic therapy among IMID pati...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-12-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118217301044 |
| _version_ | 1828836692515094528 |
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| author | Shiang-Fen Huang Ming-Han Chen Fu-Der Wang Chang-Youh Tsai Chang-Phone Fung Wei-Juin Su |
| author_facet | Shiang-Fen Huang Ming-Han Chen Fu-Der Wang Chang-Youh Tsai Chang-Phone Fung Wei-Juin Su |
| author_sort | Shiang-Fen Huang |
| collection | DOAJ |
| description | Background: Active tuberculosis (TB) in patients with latent tuberculosis infection (LTBI) was associated with use of biological agents for immune-mediated inflammatory disorders (IMIDs). For decreasing active TB, isoniazid prophylaxis therapy was administered before biologic therapy among IMID patients with LTBI. However, for patients who had been received biologics for a long time with unknown status of LTBI or exposure history of active TB, the prevalence of LTBI and efficacy of isoniazid therapy were unclear. Method: A retrospective cohort study was conducted during 2012–2014 in a tertiary medical center in Taiwan, and the incidence case of active TB was identified by the national TB registration system on October 1, 2015. Results: All 382 patients with 1532 person-years were followed up, the initial prevalence of LTBI by positive interferon-gamma releasing assay (IGRA+) was 17.5%. The prevalence of LTBI was increased in elder age (>20%, p < 0.05), chronic kidney disease (33%, p < 0.05), metabolic syndrome (26.3%, p < 0.05), but not related to the type of IMIDs or biologics. The crude incidences of TB were increased in elders (53.3/1000 person-year), abnormal chest film (49.6/1000 person-year), administration of tocilizumab (13.6/1000 person-year), and metabolic syndrome (56.1/1000 person-year), respectively. Among patents with LTBI, the incidence of active TB was lower in patients with isoniazid therapy (9.2/1000 person-year, p = 0.02) than without isoniazid therapy (92.2/1000 person-years), regardless the timing of initiating isoniazid therapy (p > 0.05). Conclusion: Isoniazid therapy can prevent active TB from LTBI despite of the timing of biologics administration. Keywords: DMARD, Isoniazid, Tuberculosis |
| first_indexed | 2024-12-12T18:26:02Z |
| format | Article |
| id | doaj.art-33cddceb0aeb446baf2e8e0b0d5c8834 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-12T18:26:02Z |
| publishDate | 2018-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-33cddceb0aeb446baf2e8e0b0d5c88342022-12-22T00:16:01ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822018-12-01516784793Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in TaiwanShiang-Fen Huang0Ming-Han Chen1Fu-Der Wang2Chang-Youh Tsai3Chang-Phone Fung4Wei-Juin Su5Institution of Clinical Medicine, National Yang-Ming University, Taiwan, ROC; Division of Infectious Disease, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taiwan, ROCInstitution of Clinical Medicine, National Yang-Ming University, Taiwan, ROC; Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan, ROCDivision of Infectious Disease, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taiwan, ROCInstitution of Clinical Medicine, National Yang-Ming University, Taiwan, ROC; Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan, ROCInstitution of Clinical Medicine, National Yang-Ming University, Taiwan, ROC; Division of Infectious Disease, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Corresponding author. Division of Infectious Disease, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. Fax: +886 2 28730052.School of Medicine, National Yang-Ming University, Taiwan, ROC; Department of Chest Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Corresponding author. Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. Fax: +886 2 28740725.Background: Active tuberculosis (TB) in patients with latent tuberculosis infection (LTBI) was associated with use of biological agents for immune-mediated inflammatory disorders (IMIDs). For decreasing active TB, isoniazid prophylaxis therapy was administered before biologic therapy among IMID patients with LTBI. However, for patients who had been received biologics for a long time with unknown status of LTBI or exposure history of active TB, the prevalence of LTBI and efficacy of isoniazid therapy were unclear. Method: A retrospective cohort study was conducted during 2012–2014 in a tertiary medical center in Taiwan, and the incidence case of active TB was identified by the national TB registration system on October 1, 2015. Results: All 382 patients with 1532 person-years were followed up, the initial prevalence of LTBI by positive interferon-gamma releasing assay (IGRA+) was 17.5%. The prevalence of LTBI was increased in elder age (>20%, p < 0.05), chronic kidney disease (33%, p < 0.05), metabolic syndrome (26.3%, p < 0.05), but not related to the type of IMIDs or biologics. The crude incidences of TB were increased in elders (53.3/1000 person-year), abnormal chest film (49.6/1000 person-year), administration of tocilizumab (13.6/1000 person-year), and metabolic syndrome (56.1/1000 person-year), respectively. Among patents with LTBI, the incidence of active TB was lower in patients with isoniazid therapy (9.2/1000 person-year, p = 0.02) than without isoniazid therapy (92.2/1000 person-years), regardless the timing of initiating isoniazid therapy (p > 0.05). Conclusion: Isoniazid therapy can prevent active TB from LTBI despite of the timing of biologics administration. Keywords: DMARD, Isoniazid, Tuberculosishttp://www.sciencedirect.com/science/article/pii/S1684118217301044 |
| spellingShingle | Shiang-Fen Huang Ming-Han Chen Fu-Der Wang Chang-Youh Tsai Chang-Phone Fung Wei-Juin Su Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan Journal of Microbiology, Immunology and Infection |
| title | Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan |
| title_full | Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan |
| title_fullStr | Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan |
| title_full_unstemmed | Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan |
| title_short | Efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune-mediated inflammatory disorders – A retrospective cohort study in Taiwan |
| title_sort | efficacy of isoniazid salvage therapy for latent tuberculosis infection in patients with immune mediated inflammatory disorders a retrospective cohort study in taiwan |
| url | http://www.sciencedirect.com/science/article/pii/S1684118217301044 |
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