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논문 기본 정보

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저자정보
Ashish Agarwal (All India Institute of Medical Sciences) Saurabh Kedia (All India Institute of Medical Sciences) Saransh Jain (All India Institute of Medical Sciences) Vipin Gupta (All India Institute of Medical Sciences) Sawan Bopanna (All India Institute of Medical Sciences) Dawesh P Yadav (All India Institute of Medical Sciences) Sandeep Goyal (All India Institute of Medical Sciences) Venigalla Pratap Mouli (All India Institute of Medical Sciences) Rajan Dhingra (All India Institute of Medical Sciences) Govind Makharia (All India Institute of Medical Sciences) Vineet Ahuja (All India Institute of Medical Sciences)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.16 No.4
발행연도
2018.1
수록면
588 - 598 (11page)

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Background/Aims: The data on the risk of tuberculosis (TB) reactivation with infliximab (IFX) in patients with inflammatory bowel disease (IBD) from TB endemic countries, like India, is limited. The risk of TB reactivation on IFX and its predictors in patients with IBD was assessed. Methods: This retrospective review included consecutive patients with IBD who received IFX, and were on follow-up from January 2005 to November 2017. The data was recorded on age/disease duration, indications for IFX, screening for latent tuberculosis (LTB) before IFX, response to IFX, incidence and duration when TB developed after IFX, and type of TB (pulmonary [PTB]/extra-pulmonary [EPTB]/disseminated). Results: Of 69 patients (22 ulcerative colitis/47 Crohn’s disease; mean age, 35.6±14.5 years; 50.7% males; median follow-up duration after IFX, 19 months [interquartile range, 5.5–48.7 months]), primary non-response at 8 weeks and secondary loss of response at 26 and 52 weeks were seen in 14.5%, 6% and 15% patients respectively. Prior to IFX, all patients were screened for LTB, 8 (11.6%) developed active TB (disseminated, 62.5%; EPTB, 25%; PTB, 12.5%) after a median of 19 weeks (interquartile range, 14.0–84.5 weeks) of IFX. Of these 8 patients’ none had LTB, even when 7 of 8 were additionally screened with contrast-enhanced chest tomography. Though not statistically significant, more patients with Crohn’s disease than ulcerative colitis (14.9% vs. 4.5%, P=0.21), and those with past history of TB (25% vs. 9.8%, P=0.21), developed TB. Age, gender, disease duration, or extraintestinal manifestations could not predict TB reactivation. Conclusions: There is an extremely high rate of TB with IFX in Indian patients with IBD. Current screening techniques are ineffective and it is difficult to predict TB after IFX. (Intest Res 2018;16:588-598)

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참고문헌 (6)

참고문헌 신청
Prashant Singh / 2017 / Pivot to Asia: inflammatory bowel disease burden / Intestinal research 15(1):138~141 dbpia Dong Il Park / 2018 / Asian Organization for Crohn’s and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment / Intestinal research 16(1):4~16 dbpia Chen-Wang Chang / 2014 / Safety and Efficacy of Adalimumab for Patients With Moderate to Severe Crohn’s Disease: The Taiwan Society of Inflammatory Bowel Disease (TSIBD) Study / Intestinal research 12(4):287~292 dbpia 김경희 / 2011 / Serial Interferon-gamma Release Assays for the Diagnosis of Latent Tuberculosis Infection in Patients Treated with Immunosuppressive Agents / Annals of Laboratory Medicine 31(4):271~278 dbpia Silverberg MS / 2005 / Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology / Can J Gastroenterol 19(Suppl A):5A~36A Crossref

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