Lee J, Kim E, Jang EJ et al.
Seoul National University College of Medicine, 37990, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul, Korea (the Republic of) ; email@example.com.
Annals of the American Thoracic Society. Mar 2017.
Current guidelines recommend that all patients undergoing treatment with a tumor necrosis factor-α antagonists should receive screening for latent tuberculosis and appropriate treatment before initiating the inhibitor. However, no well-designed study has shown the efficacy of treating these patients for latent tuberculosis.To compare the risk of active tuberculosis between tumor-necrosis-factorantagonists users who have received treatment for latent tuberculosis and those who have not.We performed a national-level retrospective cohort study in South Korea, an intermediate-tuberculosis burden country, by analyzing obligatory national health insurance claims database between January 1, 2011 and December 31, 2013. Primary outcome, the incidence of active tuberculosis, was measured as the occurrence of ICD-10 diagnosis of tuberculosis and prescription of at least two anti-tuberculosis drugs at least twice within 90 days.Among 10,863 eligible new tumor-necrosis-factorantagonists users, 2,461 (22.7%) received treatment for latent tuberculosis. Incidence rate of tuberculosis per 1000 person-years was lower for the treated group (4.07; 95% confidence interval (CI), 1.55-6.60) than the untreated group (12.34; 95% CI, 9.96-14.72). The risk for tuberculosis was significantly reduced by preventive chemotherapy (incidence rate ratio 0.33 (95% CI, 0.17-0.63).Treatment for latent tuberculosis was highly effective in preventing development of tuberculosis among tumor necrosis factor antagonists users.