Tuberculosis in biologic-naïve patients with rheumatoid arthritis - risk factors and tuberculosis characteristics

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Fältnamn	Indikatorer	Metadata
000		04750naa a2200529 4500
001		oai:DiVA.org:ltu-83661
003		SwePub
008		210414s2021 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:DiVA.org:uu-407859
009		oai:prod.swepub.kib.ki.se:147256072
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-836612 URI
024	7	a https://doi.org/10.3899/jrheum.2012512 DOI
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4078592 URI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1472560722 URI
040		a (SwePub)ltud (SwePub)uud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Karlsson Sundbaum, Johannau Uppsala universitet,Luleå tekniska universitet,Hälsa, medicin och rehabilitering,Rheumatology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Reumatologi,Luleå Univ Technol, Dept Med Sci, Luleå, Sweden.4 aut0 (Swepub:uu)johsu404
245	1 0	a Tuberculosis in biologic-naïve patients with rheumatoid arthritis - risk factors and tuberculosis characteristics
264		c 2021-04-01
264	1	b The Journal of Rheumatology Publishing Co. Ltd.c 2021
338		a print2 rdacarrier
500		a Validerad;2021;Nivå 2;2021-08-11 (alebob)
520		a ObjectiveTo investigate risk factors and characteristics of active tuberculosis (TB) in biologics-naïve rheumatoid arthritis (RA) patients.MethodsPopulation-based case-control study using the Swedish Rheumatology Quality Register, the National Patient Register and the Tuberculosis Register to identify RA cases with active TB and matched RA controls without TB 2001-2014. Clinical data were obtained from medical records. TB risk was estimated as adjusted (adj) odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariable logistic regression analyses.ResultsAfter validation of diagnoses, the study included 31 RA cases with TB, and 122 matched RA controls. All except three cases had reactivation of latent TB. Pulmonary TB dominated (84%). Ever use of methotrexate was not associated with increased TB risk (adj OR 0.8; 95% CI 0.3-2.0), whereas ever treatment with leflunomide (adj OR 6.0; 95% CI 1.5-24.6), azathioprine (adj OR 3.8; 95% CI 1.1-13.8) and prednisolone (adj OR 2.4 (95% CI 1.0-5.9) was. There were no significant differences of maximum dose of prednisolone, treatment duration with prednisolone before TB, or cumulative dose of prednisolone the year before TB diagnosis between cases and controls. Obstructive pulmonary disease was associated with an increased TB risk (adj OR 3.9; 95% CI 1.4-10.7).ConclusionSeveral RA-associated factors may contribute to the increased TB risk in biologics-naïve RA patients, making risk of TB activation difficult to predict in the individual patient. To further decrease TB in RA patients, the results suggest that screening for latent TB should also be considered in biologics-naïve patients.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
653		a rheumatoid arthritis
653		a tuberculosis
653		a biologic–naïve
653		a risk factors
653		a Medicinsk vetenskap
653		a Medical Science
700	1	a Arkema, Elizabeth V.u Karolinska Institutet4 aut
700	1	a Bruchfeld, Judithu Karolinska Institutet4 aut
700	1	a Jonsson, Jerkeru Karolinska Institutet4 aut
700	1	a Askling, Johanu Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Rheumatology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Clin Epidemiol Div, Dept Med Solna, Stockholm, Sweden.;Karolinska Inst, Rheumatol Div, Dept Med, Stockholm, Sweden.4 aut
700	1	a Baecklund, Eva,d 1956-u Uppsala universitet,Reumatologi4 aut0 (Swepub:uu)evaba786
710	2	a Luleå tekniska universitetb Hälsa, medicin och rehabilitering4 org
773	0	t Journal of Rheumatologyd : The Journal of Rheumatology Publishing Co. Ltd.g 48:8, s. 1243-1250q 48:8<1243-1250x 0315-162Xx 1499-2752
856	4	u https://doi.org/10.3899/jrheum.201251y Fulltext
856	4	u https://www.jrheum.org/content/jrheum/48/8/1243.full.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-83661
856	4 8	u https://doi.org/10.3899/jrheum.201251
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-407859
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:147256072

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Av författaren/redakt...: Karlsson Sundbau ...; Arkema, Elizabet ...; Bruchfeld, Judit ...; Jonsson, Jerker; Askling, Johan; Baecklund, Eva, ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Reumatologi och ...

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