The development of active tuberculosis after the use of infliximab

Infliximab, a medicine containing monoclonal antibodies against tumor necrosis factor alpha (TNF-α), is used to treat Crohn's disease and rheumatoid arthritis. In addition, there have been recent reports of the effectiveness of infliximab in psoriasis. Approximately 147,000 patients worldwide receive infliximab. TNF-α is thought to protect the body from infectious diseases, but there is no direct evidence that TNF-α prevents the development of tuberculosis.

American researchers at Boston University have analyzed all reports on the development of tuberculosis after the start of infliximab, which were received by the US Food and Drug Administration (FDA) before May 29, 2001.

It turned out that 70 case reports of tuberculosis after treatment with infliximab for an average of 12 weeks were recorded. In 48 patients, tuberculosis developed after 3 or fewer injections of the drug. 40 patients had concomitant extrapulmonary diseases. Tuberculosis was confirmed by biopsy in 33 patients. Of the 70 reports, 64 were from countries with a low incidence of tuberculosis.

The number of tuberculosis case reports that occurred while using infliximab was significantly higher than the reports of the development of other infectious diseases during treatment with this drug.

In addition, the incidence of reported tuberculosis cases in patients treated with infliximab is higher than the average incidence rate in the countries whose reports were reported.

Thus, active TB can develop soon after starting treatment with infliximab, so before prescribing this medication, the doctor should examine the patient for latent TB.