Active tuberculosis infection in moroccan patients with rheumatic diseases under biologic therapy: A multicenter national study

Background: The aim of this study was to evaluate the prevalence of active tuberculosis (TB) infection in Moroccan patients with rheumatic diseases under biologic therapy, and to describe the demographic characteristics of these patients as well as to explore potential risk factors. Methods: This 14...

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Published in:	International journal of mycobacteriology Vol. 11; no. 2; pp. 175 - 182
Main Authors:	Aachari, Ilham, Tahiri, Latifa, Elolemy, Gehan, Taik, Fatima, Afilal, Saloua, Fellous, Safaa, Berkchi, Jihad, Rkain, Hanan, Bahiri, Rachid, Majjad, Abderrahim, Achemlal, Lahsen, Ousehal, Soumaya, Nassar, Kawtar, Mkinsi, Ouafa, Mahha, Fatima, El Aissaoui, Asmae, Chaoui, Imane, Harzy, Taoufik, Youssoufi, Tarik, Hassikou, Hasna, Kherrab, Anass, Niamane, Radouane, Eddarami, Jalila, Ichchou, Linda, Ghozlani, Imad, El Bouchti, Imane, Abourazzak, Fatima, Razine, Rachid, Allali, Fadoua
Format:	Journal Article
Language:	English
Published:	Wolters Kluwer - Medknow Publications 01-04-2022 Medknow Publications and Media Pvt. Ltd Wolters Kluwer Medknow Publications
Subjects:	biological therapies Care and treatment disease-modifying antirheumatic drugs Health aspects infections and arthritis Prevalence studies (Epidemiology) rheumatoid arthritis spondylarthropathies Tuberculosis Morocco infections and arthritis spondylarthropathies rheumatoid arthritis disease-modifying antirheumatic drugs Biological therapies
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Summary:	Background: The aim of this study was to evaluate the prevalence of active tuberculosis (TB) infection in Moroccan patients with rheumatic diseases under biologic therapy, and to describe the demographic characteristics of these patients as well as to explore potential risk factors. Methods: This 14-year nationally representative multicenter study enrolled Moroccan patients with rheumatic diseases who had been treated with biologic therapy. Patient medical records were reviewed retrospectively for demographic characteristics, underlying rheumatic diseases, associated comorbidities, and TB-related data. Results: In total, 1407 eligible patients were studied, detailed records were obtained for only 130 patients; 33 cases with active TB were identified at an estimated prevalence rate of 2.3%. The mean age was 42.9 ± 12 years and 75.8% were males. Ankylosing spondylitis accounted for 84.8% of active TB cases, and the majority of the cases (31/33) occurred among antitumor necrosis factor-alpha (TNF-α) users. A total of 8 out of 33 patients were positive at initial latent TB infection (LTBI) screening by tuberculin skin test and/or interferon-gamma release assay. Consumption of unpasteurized dairy products (odds ratio [OR], 34.841; 95% confidence interval [CI], 3.1-389.7; P = 0.04), diabetes (OR, 38.468; 95% CI, 1.6-878.3; P = 0,022), smoking (OR, 3.941; 95% CI, 1-159.9; P = 0.047), and long biologic therapy duration (OR, 1.991; 95% CI, 1.4-16.3; P = 0.001) were identified as risk factors for developing active TB. Conclusion: Moroccan patients with rheumatic diseases under anti-TNF-α agents are at an increased TB risk, especially when risk factors are present. Strict initial screening and regular monitoring of LTBI is recommended for patients living in high TB prevalence areas.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2212-5531 2212-554X
DOI:	10.4103/ijmy.ijmy_153_20