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Article: Risk of tuberculosis in patients with spondyloarthritis: data from a centralized electronic database in Hong Kong

TitleRisk of tuberculosis in patients with spondyloarthritis: data from a centralized electronic database in Hong Kong
Authors
KeywordsSpondyloarthritis
Tuberculosis
Disease modifying anti-rheumatic drugs
Glucocorticoid
Infliximab
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmusculoskeletdisord/
Citation
BMC Musculoskeletal Disorders, 2020, v. 21 n. 1, p. article no. 832 How to Cite?
AbstractBackground/ objective: Tuberculosis (TB) is one of the most infectious comorbidities in spondyloarthritis (SpA). Our goals were to determine the crude incidence rate of and risk factors for TB in SpA. Method: Clinical data of 2984 patients with SpA from 11 rheumatology centres were reviewed. This included demographics, duration of follow-up, comorbidities including diabetes, chronic kidney disease, chronic heart disease, chronic lung disease, stroke and malignancies, date of diagnosis of tuberculosis, use of non-steroidal anti-inflammatory drugs, duration of glucocorticoid therapy for more than 6 months, conventional (cDMARD) and biological (bDMARD) disease modifying anti-rheumatic drug therapies. Crude incidence rates were reported. Cox regression models were used to determine the risk factors for TB in patients with SpA. Results: Forty-three patients had TB, of which 4 (9.3%) were extra-pulmonary. The crude incidence rate of TB was 1.57 in patients with SpA, compared with 0.58 in the general population in Hong Kong. Independent risk factors identified from the multivariate Cox regression model were: alcohol use (HR 2.62; p = 0.03), previous TB (HR 13.62; p < 0.001), chronic lung disease (HR 3.39; p = 0.004), duration of glucocorticoid therapy greater than 6 months (HR 3.25; p = 0.01) and infliximab therapy (HR 5.06; p < 0.001). Age was associated with decreased risk (HR 0.93; p < 0.001). Conclusion: Incidence of TB was higher in patients with SpA. Glucocorticoid therapy beyond 6 months and infliximab therapy increased the risk of TB. Rheumatologists should avoid prolonged use of glucocorticoids and consider DMARDs other than infliximab in the treatment of at-risk patients.
Persistent Identifierhttp://hdl.handle.net/10722/295327
ISSN
2023 Impact Factor: 2.2
2023 SCImago Journal Rankings: 0.714
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCiang, NCO-
dc.contributor.authorChan, SCW-
dc.contributor.authorLau, CS-
dc.contributor.authorChiu, ETF-
dc.contributor.authorChung, HY-
dc.date.accessioned2021-01-11T13:58:32Z-
dc.date.available2021-01-11T13:58:32Z-
dc.date.issued2020-
dc.identifier.citationBMC Musculoskeletal Disorders, 2020, v. 21 n. 1, p. article no. 832-
dc.identifier.issn1471-2474-
dc.identifier.urihttp://hdl.handle.net/10722/295327-
dc.description.abstractBackground/ objective: Tuberculosis (TB) is one of the most infectious comorbidities in spondyloarthritis (SpA). Our goals were to determine the crude incidence rate of and risk factors for TB in SpA. Method: Clinical data of 2984 patients with SpA from 11 rheumatology centres were reviewed. This included demographics, duration of follow-up, comorbidities including diabetes, chronic kidney disease, chronic heart disease, chronic lung disease, stroke and malignancies, date of diagnosis of tuberculosis, use of non-steroidal anti-inflammatory drugs, duration of glucocorticoid therapy for more than 6 months, conventional (cDMARD) and biological (bDMARD) disease modifying anti-rheumatic drug therapies. Crude incidence rates were reported. Cox regression models were used to determine the risk factors for TB in patients with SpA. Results: Forty-three patients had TB, of which 4 (9.3%) were extra-pulmonary. The crude incidence rate of TB was 1.57 in patients with SpA, compared with 0.58 in the general population in Hong Kong. Independent risk factors identified from the multivariate Cox regression model were: alcohol use (HR 2.62; p = 0.03), previous TB (HR 13.62; p < 0.001), chronic lung disease (HR 3.39; p = 0.004), duration of glucocorticoid therapy greater than 6 months (HR 3.25; p = 0.01) and infliximab therapy (HR 5.06; p < 0.001). Age was associated with decreased risk (HR 0.93; p < 0.001). Conclusion: Incidence of TB was higher in patients with SpA. Glucocorticoid therapy beyond 6 months and infliximab therapy increased the risk of TB. Rheumatologists should avoid prolonged use of glucocorticoids and consider DMARDs other than infliximab in the treatment of at-risk patients.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmusculoskeletdisord/-
dc.relation.ispartofBMC Musculoskeletal Disorders-
dc.rightsBMC Musculoskeletal Disorders. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectSpondyloarthritis-
dc.subjectTuberculosis-
dc.subjectDisease modifying anti-rheumatic drugs-
dc.subjectGlucocorticoid-
dc.subjectInfliximab-
dc.titleRisk of tuberculosis in patients with spondyloarthritis: data from a centralized electronic database in Hong Kong-
dc.typeArticle-
dc.identifier.emailLau, CS: cslau@hku.hk-
dc.identifier.emailChung, HY: jameschy@hku.hk-
dc.identifier.authorityLau, CS=rp01348-
dc.identifier.authorityChung, HY=rp02330-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12891-020-03855-5-
dc.identifier.pmid33302934-
dc.identifier.pmcidPMC7730739-
dc.identifier.scopuseid_2-s2.0-85097420037-
dc.identifier.hkuros320801-
dc.identifier.volume21-
dc.identifier.issue1-
dc.identifier.spagearticle no. 832-
dc.identifier.epagearticle no. 832-
dc.identifier.isiWOS:000599994900004-
dc.publisher.placeUnited Kingdom-

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