Abstract
Tumour necrosis factor-alpha antagonist drugs represent a significant advance in the treatment of inflammatory diseases, such as rheumatoid arthritis, spondyloarthropathies, and intestinal inflammatory disease. The increase in tuberculosis with infliximab is known, but there is less data available that specifically associates tuberculosis with adalimumab. We present the cases of 2 patients with rheumatoid arthritis and one patient with ankylopoietic spondylitis on treatment with adalimumab, who developed pulmonary and disseminated tuberculosis despite following the screening and prophylaxis measures recommended in guidelines. We also review the association between treatment with tumour necrosis factor-alpha antagonists and tuberculosis.
Copyright (c) 2009 SEPAR. Published by Elsevier Espana. All rights reserved.
Publication types
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Case Reports
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English Abstract
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Review
MeSH terms
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Adalimumab
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Adrenal Cortex Hormones / adverse effects
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Adrenal Cortex Hormones / therapeutic use
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Adult
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Antibodies, Monoclonal / adverse effects*
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Humanized
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Antitubercular Agents / therapeutic use
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Arthritis, Rheumatoid / complications
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Arthritis, Rheumatoid / drug therapy
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Disease Susceptibility
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Female
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Humans
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Immunocompromised Host
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Immunosuppressive Agents / adverse effects*
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Immunosuppressive Agents / therapeutic use
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Male
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Methotrexate / adverse effects
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Methotrexate / therapeutic use
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Middle Aged
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Opportunistic Infections / drug therapy
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Opportunistic Infections / etiology*
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Spondylitis, Ankylosing / complications
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Spondylitis, Ankylosing / drug therapy
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Tuberculosis, Miliary / drug therapy
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Tuberculosis, Miliary / etiology
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Tuberculosis, Pulmonary / drug therapy
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Tuberculosis, Pulmonary / etiology*
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Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Substances
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Adrenal Cortex Hormones
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antitubercular Agents
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Immunosuppressive Agents
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Tumor Necrosis Factor-alpha
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Adalimumab
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Methotrexate