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Updated: May 2, 2026
A 3D Human Lung Tissue Model for Functional Studies on Mycobacterium tuberculosis Infection
Published on: October 5, 2015
Active tuberculosis risk with tumor necrosis factor inhibitors after treating latent tuberculosis
Minkyung Kwon1, Mindong Sung, Yong-Jin Kwon
1From the *Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; †Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI; and ‡Division of Infectious Disease, Department of Internal Medicine, and §Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea.
Background:
Active tuberculosis (TB) risk increases during anti-tumor necrosis factor (TNF) therapy; therefore, latent TB infection (LTBI) screening is recommended in potential TNF inhibitor users. It is unclear whether anti-TNF therapy increases the risk of active TB infection even after standard LTBI treatment.
Objective:
The objective of this study was to compare the risk of active TB development in LTBI-positive versus LBTI-negative TNF inhibitor users following the current national LTBI treatment guidelines for LTBI.
Methods:
We retrospectively studied 949 TNF inhibitor users with immune-mediated inflammatory diseases from 2005 to 2012 at the Yonsei University Health System. We compared the incidence of active TB among LTBI-positive TNF inhibitor users treated according to national guidelines (n = 256) and LTBI-negative TNF inhibitor users (n = 521), using Poisson regression.
Results:
The active TB incidence was 1107 per 100,000 patient-years in LTBI-positive TNF inhibitor users who received standard LTBI treatment and 490 per 100,000 patient-years in LTBI-negative TNF inhibitor users. Analysis showed that despite this numerical trend active TB risk was not statistically significantly elevated in LTBI-positive versus LTBI-negative TNF inhibitor users (incidence risk ratio, 2.15; P = 0.24; 95% confidence interval, 0.6-7.7).
Conclusions:
This study demonstrated no statistically significantly increased risk of active TB in LTBI-positive TNF inhibitor users who received standard LTBI treatment compared with LTBI-negative TNF inhibitor users.
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