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Risk of tuberculosis is higher with anti–tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three‐year prospective french research axed on tolerance of biotherapies registry

Open access
Tubach, F., Salmon, D., Ravaud, P., Allanore, Y., Goupille, P., Bréban, M., Pallot‐Prades, B., Pouplin, S., Sacchi, A., Chichemanian, R. M., Bretagne, S., Emilie, D., Lemann, M., Lorthololary, O., Mariette, X.·2009·Arthritis & Rheumatism

Abstract

Objective: Tuberculosis (TB) is associated with anti–tumor necrosis factor (anti‐TNF) monoclonal antibody (mAb) therapy, but whether this association is drug‐specific remains a concern. Our objective was to describe cases of TB associated with anti‐TNF mAb therapy, identify risk factors, and estimate the incidence. Methods: We conducted an incidence study and a case–control analysis to investigate the risk of newly diagnosed TB associated with the use of anti‐TNF agents. As part of the French Research Axed on Tolerance of Biotherapies (RATIO) registry, for 3 years we collected cases of TB among French patients receiving anti‐TNF mAb therapy for any indication; for each case, 2 patients treated with anti‐TNF agents served as control subjects. Results: We collected 69 cases of TB in patients treated for rheumatoid arthritis (n = 40), spondylarthritides (n = 18), inflammatory colitis (n = 9), psoriasis (n = 1) and Behçet's disease (n = 1) with infliximab (n = 36), adalimumab (n = 28), and etanercept (n = 5). None of the patients had received correct chemoprophylactic treatment. The sex‐ and age‐adjusted incidence rate of TB was 116.7 per 100,000 patient‐years. The standardized incidence ratio (SIR) was 12.2 (95% confidence interval [95% CI] 9.7–15.5) and was higher for therapy with infliximab and adalimumab than for therapy with etanercept (SIR 18.6 [95% CI 13.4–25.8] and SIR 29.3 [95% CI 20.3–42.4] versus SIR 1.8 [95% CI 0.7–4.3], respectively). In the case–control analysis, exposure to infliximab or adalimumab versus etanercept was an independent risk factor for TB (odds ratio [OR] 13.3 [95% CI 2.6–69.0] and OR 17.1 [95% CI 3.6–80.6], respectively). Other risk factors were age, the first year of anti‐TNF mAb treatment, and being born in an endemic area. Conclusion: The risk of TB is higher for patients receiving anti‐TNF mAb therapy than for those receiving soluble TNF receptor therapy. The increased risk with early anti‐TNF treatment and the absence of correct chemoprophylactic treatment favor the reactivation of latent TB.

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Metadata

Authors
Tubach, F., Salmon, D., Ravaud, P., Allanore, Y., Goupille, P., Bréban, M., Pallot‐Prades, B., Pouplin, S., Sacchi, A., Chichemanian, R. M., Bretagne, S., Emilie, D., Lemann, M., Lorthololary, O., & Mariette, X.
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
2009-06-29
Volume
60
Issue
7
Pages
1884-1894
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
OpenAlex
W2070353058
Cited by
632
References
23
FWCI
39.53
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: Risk of tuberculosis is higher with anti–tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three‐year prospective french research axed on tolerance of biotherapies registry. https://app.cochat.ai/papers/10.1002/art.24632
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Tubach, F., Salmon, D., Ravaud, P., Allanore, Y., Goupille, P., Bréban, M., Pallot‐Prades, B., Pouplin, S., Sacchi, A., Chichemanian, R. M., Bretagne, S., Emilie, D., Lemann, M., Lorthololary, O., & Mariette, X. (2009). Risk of tuberculosis is higher with anti–tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three‐year prospective french research axed on tolerance of biotherapies registry. Arthritis & Rheumatism. https://doi.org/10.1002/art.24632

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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