Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy.
- Title
- Clinical Features and Outcomes of Tuberculosis in Inflammatory Bowel Disease Patients Treated with Anti-tumor Necrosis Factor Therapy.
- Other Titles
- 항 Tumor Necrosis Factor 제제 치료 중인 염증성 장질환 환자에서 발생한 결핵의 임상적 특징과 예후
- Author
- 은창수
- Keywords
- Tumor necrosis factor inhibitors; Inflammatory bowel diseases; Tuberculosis
- Issue Date
- 2020-01
- Publisher
- Korean Society of Gastroenterology
- Citation
- The Korean journal of gastroenterology, v. 75, no. 1, page. 29-38
- Abstract
- Background/Aims
Anti-tumor necrosis factor (TNF) therapy is used widely for the treatment of inflammatory bowel disease (IBD). In the present study, the characteristics and outcomes of tuberculosis (TB) in IBD patients treated with anti-TNF therapy were compared with those of non-IBD TB patients.
Methods
Twenty-five IBD patients who initially developed TB during anti-TNF therapy were enrolled in this study. Seventy-five age- and gender-matched non-IBD TB patients were selected as controls in a 1:3 ratio.
Results
The proportion of non-respiratory symptoms was higher in the IBD patients than in the non-IBD patients (12 [48.0%] in the IBD patients vs. 15 [20.0%] in the non-IBD patients; p=0.009). Eight (32.0%) IBD patients and 19 (25.3%) non-IBD patients had extra-pulmonary lesions (p=0.516). The frequency of positive smear results for acid-fast bacilli (AFB) was significantly higher in the non-IBD patients than in the IBD patients (three [12.0%] IBD patients vs. 27 [36.0%] non-IBD patients; p=0.023). Active TB was cured in 24 (96.0%) patients in the IBD group and in 70 (93.3%) patients in the non-IBD group (p=0.409). The TB-related mortality rates were 4.0% and 1.3% in the IBD patients and non-IBD patients, respectively (p=0.439).
Conclusions
The rate of extrapulmonary involvement, side effects of anti-TB medications, and clinical outcomes did not differ between the IBD patients who initially developed TB during anti-TNF therapy and non-IBD patients with TB. On the other hand, the IBD patients had a lower rate of AFB smear positivity and a higher proportion of non-respiratory symptoms.
- URI
- https://synapse.koreamed.org/articles/1142220https://repository.hanyang.ac.kr/handle/20.500.11754/158855
- ISSN
- 1598-9992; 2233-6869
- DOI
- 10.4166/kjg.2020.75.1.29
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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