Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil)
Objectives: To assess the incidence of tuberculosis and to screen for latent tuberculosis infection among Brazilians with rheumatoid arthritis using biologics in clinical practice. Patients and methods: This cohort study used data from the Brazilian Registry of Biological Therapies in Rheum...
| id |
ir-2011-9627 |
|---|---|
| recordtype |
dspace |
| spelling |
ir-2011-96272023-11-22T14:50:23Z Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) Incidência de tuberculose em pacientes com artrite reumatoide em uso de bloqueadores do TNF no Brasil: dados do Registro Brasileiro de Monitoração de Terapias Biológicas BiobadaBrasil YONEKURA, Claudia Leiko Yonekura OLIVEIRA, Renê Donizeti Ribeiro de RANZA, Roberto RANZOLIN, Aline HAYATA, André Luiz Shinji SILVEIRA, Inês Guimarães da CARVALHO, Hellen Mary da Silveira de MORAES, Julio Cesar Bertacini de ABREU, Mirhelen Mendes de VALIM, Valéria BIANCHI, Washington Alves BRENOL, Claiton Viegas PEREIRA, Ivânio Alves COSTA, Izaias Pereira da MACIEIRA, José Caetano GUEDES-BARBOSA, Luiz Sérgio BERTOLO, Manoel Barros CUNHA, Maria de Fátima Lobato da SILVA, Marília Barreto Gameiro FREIRE, Marlene SCHEINBERG, Morton Aaron TOLEDO, Roberto Acayaba de OLIVEIRA, Sheila Knupp Feitosa de FERNANDES, Vander PINHEIRO, Marcelo de Medeiros CASTRO, Gláucio Ricardo Werner de VIEIRA, Walber Pinto BAAKLINI, Cesar Emile RUFFINO-NETTO, Antonio PINHEIRO, Geraldo da Rocha Castelar LAURINDO, Ieda Maria Magalhães LOUZADA-JUNIOR, Paulo TITTON, David C. DUARTE, Angela MIRANDA, Jose R. S. Artrite reumatóide Tuberculose Agentes biológicos - Artrite reumatoide CNPQ::CIENCIAS DA SAUDE Objectives: To assess the incidence of tuberculosis and to screen for latent tuberculosis infection among Brazilians with rheumatoid arthritis using biologics in clinical practice. Patients and methods: This cohort study used data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas - BiobadaBrasil), from 01/2009 to 05/2013, encompassing 1552 treatments, including 415 with only synthetic disease-modifying anti-rheumatic drugs, 942 synthetic DMARDs combined with anti-tumor necrosis factor (etanercept, infliximab, adalimumab) and 195 synthetic DMARDs combined with other biologics (abatacept, rituximab and tocilizumab). The occurrence of tuberculosis and the drug exposure time were assessed, and screening for tuberculosis was performed. Statistical analysis: Unpaired t-test and Fisher's two-tailed test; p < 0.05. Results: The exposure times were 981 patient-years in the controls, 1744 patient-years in the anti-TNF group (adalimumab = 676, infliximab = 547 and etanercept = 521 patient-years) and 336 patient-years in the other biologics group. The incidence rates of tuberculosis were 1.01/1000 patient-years in the controls and 2.87 patient-years among anti-TNF users (adalimumab = 4.43/1000 patient-years; etanercept = 1.92/1000 patient-years and infliximab = 1.82/1000 patient-years). No cases of tuberculosis occurred in the other biologics group. The mean drug exposure time until the occurrence of tuberculosis was 27(11) months for the anti-TNF group. Conclusions: The incidence of tuberculosis was higher among users of synthetic DMARDs and anti-TNF than among users of synthetic DMARDs and synthetic DMARDs and non-anti-TNF biologics and also occurred later, suggesting infection during treatment and no screening failure. Objetivos: Avaliar incidência de tuberculose e triagem para tuberculose latente em brasileiros com artrite reumatoide em uso de agentes biológicos na prática clinica. Pacientes e métodos: Estudo de coorte com dados do Registro Brasileiro de Monitoração de Terapias Biológicas (BiobadaBrasil), de 01/2009 a 05/2013, abrangeu 1.552 tratamentos, 415 somente com drogas modificadoras do curso da doença (MMCDs) sintéticas, 942 MMCDs sintéticas em associação com anti-TNF (etanercepte, infliximabe, adalimumabe) e 195 MMCDs sintéticas em associação com outros biológicos (abatacepte, rituximabe e tocilizumabe). Avaliaram-se ocorrência de tuberculose, tempo de exposição às drogas e triagem para TB. Análise estatística: teste t não pareado e teste de Fisher bicaudal; p < 0,05. Resultados: O tempo de exposição dos controles foi de 981 pacientes-ano, do grupo de anti-TNF foi de 1.744 pacientes-ano (adalimumabe = 676, infliximabe = 547 e etanercepte = 521 pacientes-ano) e o de outros biológicos de 336 pacientes-ano. A incidência de TB foi de 1,01/1.000 pacientes-ano nos controles e de 2,87 pacientes-ano nos usuários de anti-TNF (adalimumabe = 4,43/1.000 pacientes-ano; etanercepte = 1,92/1.000 pacientes-ano e infliximabe = 1,82/1.000 pacientes-ano). Não houve casos de tuberculose no grupo de outros biológicos. O tempo médio de exposição até a ocorrência de tuberculose foi de 27(11) meses para o grupo anti-TNF. Conclusões: A incidência de tuberculose foi maior nos usuários de MMCDs sintéticas e anti-TNF do que nos usuários de MMCDs sintéticas e de MMCDs sintéticas e biológicos não anti-TNF, e também mais tardia, sugerindo infecção durante o tratamento, e não falha na triagem. 2018-03-27T12:01:38Z 2018-03-27T12:01:38Z 2017 Artigo de Periódico YONEKURA, Claudia Leiko et al. Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas - BiobadaBrasil). Revista Brasileira de Reumatologia, São Paulo, v. 57, supl. 2, p. s477-s483, 2017. Disponível em: <http://repositorio.ufpa.br/jspui/handle/2011/9627>. Acesso em:. 1809-4570 0482-5004 http://repositorio.ufpa.br/jspui/handle/2011/9627 http://dx.doi.org/10.1016/j.rbre.2017.05.005 eng Revista Brasileira de Reumatologia Acesso Aberto application/pdf application/pdf Universidade Federal do Pará Brasil UFPA http://www.scielo.br/pdf/rbr/v57s2/0482-5004-rbr-57-s2-s477.pdf |
| institution |
Repositório Institucional - Universidade Federal do Pará |
| collection |
RI-UFPA |
| language |
eng |
| topic |
Artrite reumatóide Tuberculose Agentes biológicos - Artrite reumatoide CNPQ::CIENCIAS DA SAUDE |
| spellingShingle |
Artrite reumatóide Tuberculose Agentes biológicos - Artrite reumatoide CNPQ::CIENCIAS DA SAUDE YONEKURA, Claudia Leiko Yonekura Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) |
| topic_facet |
Artrite reumatóide Tuberculose Agentes biológicos - Artrite reumatoide CNPQ::CIENCIAS DA SAUDE |
| description |
Objectives:
To assess the incidence of tuberculosis and to screen for latent tuberculosis infection among Brazilians with rheumatoid arthritis using biologics in clinical practice.
Patients and methods:
This cohort study used data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas - BiobadaBrasil), from 01/2009 to 05/2013, encompassing 1552 treatments, including 415 with only synthetic disease-modifying anti-rheumatic drugs, 942 synthetic DMARDs combined with anti-tumor necrosis factor (etanercept, infliximab, adalimumab) and 195 synthetic DMARDs combined with other biologics (abatacept, rituximab and tocilizumab). The occurrence of tuberculosis and the drug exposure time were assessed, and screening for tuberculosis was performed. Statistical analysis: Unpaired t-test and Fisher's two-tailed test; p < 0.05.
Results:
The exposure times were 981 patient-years in the controls, 1744 patient-years in the anti-TNF group (adalimumab = 676, infliximab = 547 and etanercept = 521 patient-years) and 336 patient-years in the other biologics group. The incidence rates of tuberculosis were 1.01/1000 patient-years in the controls and 2.87 patient-years among anti-TNF users (adalimumab = 4.43/1000 patient-years; etanercept = 1.92/1000 patient-years and infliximab = 1.82/1000 patient-years). No cases of tuberculosis occurred in the other biologics group. The mean drug exposure time until the occurrence of tuberculosis was 27(11) months for the anti-TNF group.
Conclusions:
The incidence of tuberculosis was higher among users of synthetic DMARDs and anti-TNF than among users of synthetic DMARDs and synthetic DMARDs and non-anti-TNF biologics and also occurred later, suggesting infection during treatment and no screening failure. |
| format |
Artigo |
| author |
YONEKURA, Claudia Leiko Yonekura |
| author2 |
OLIVEIRA, Renê Donizeti Ribeiro de RANZA, Roberto RANZOLIN, Aline HAYATA, André Luiz Shinji SILVEIRA, Inês Guimarães da CARVALHO, Hellen Mary da Silveira de MORAES, Julio Cesar Bertacini de ABREU, Mirhelen Mendes de VALIM, Valéria BIANCHI, Washington Alves BRENOL, Claiton Viegas PEREIRA, Ivânio Alves COSTA, Izaias Pereira da MACIEIRA, José Caetano GUEDES-BARBOSA, Luiz Sérgio BERTOLO, Manoel Barros CUNHA, Maria de Fátima Lobato da SILVA, Marília Barreto Gameiro FREIRE, Marlene SCHEINBERG, Morton Aaron TOLEDO, Roberto Acayaba de OLIVEIRA, Sheila Knupp Feitosa de FERNANDES, Vander PINHEIRO, Marcelo de Medeiros CASTRO, Gláucio Ricardo Werner de VIEIRA, Walber Pinto BAAKLINI, Cesar Emile RUFFINO-NETTO, Antonio PINHEIRO, Geraldo da Rocha Castelar LAURINDO, Ieda Maria Magalhães LOUZADA-JUNIOR, Paulo TITTON, David C. DUARTE, Angela MIRANDA, Jose R. S. |
| author2Str |
OLIVEIRA, Renê Donizeti Ribeiro de RANZA, Roberto RANZOLIN, Aline HAYATA, André Luiz Shinji SILVEIRA, Inês Guimarães da CARVALHO, Hellen Mary da Silveira de MORAES, Julio Cesar Bertacini de ABREU, Mirhelen Mendes de VALIM, Valéria BIANCHI, Washington Alves BRENOL, Claiton Viegas PEREIRA, Ivânio Alves COSTA, Izaias Pereira da MACIEIRA, José Caetano GUEDES-BARBOSA, Luiz Sérgio BERTOLO, Manoel Barros CUNHA, Maria de Fátima Lobato da SILVA, Marília Barreto Gameiro FREIRE, Marlene SCHEINBERG, Morton Aaron TOLEDO, Roberto Acayaba de OLIVEIRA, Sheila Knupp Feitosa de FERNANDES, Vander PINHEIRO, Marcelo de Medeiros CASTRO, Gláucio Ricardo Werner de VIEIRA, Walber Pinto BAAKLINI, Cesar Emile RUFFINO-NETTO, Antonio PINHEIRO, Geraldo da Rocha Castelar LAURINDO, Ieda Maria Magalhães LOUZADA-JUNIOR, Paulo TITTON, David C. DUARTE, Angela MIRANDA, Jose R. S. |
| title |
Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) |
| title_short |
Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) |
| title_full |
Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) |
| title_fullStr |
Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) |
| title_full_unstemmed |
Incidence of tuberculosis among patients with rheumatoid arthritis using TNF blockers in Brazil: data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas – BiobadaBrasil) |
| title_sort |
incidence of tuberculosis among patients with rheumatoid arthritis using tnf blockers in brazil: data from the brazilian registry of biological therapies in rheumatic diseases (registro brasileiro de monitoração de terapias biológicas – biobadabrasil) |
| publisher |
Universidade Federal do Pará |
| publishDate |
2018 |
| url |
http://repositorio.ufpa.br/jspui/handle/2011/9627 http://dx.doi.org/10.1016/j.rbre.2017.05.005 |
| _version_ |
1832602801211965440 |
| score |
11.755432 |