Characteristics of tuberculosis in patients with rheumatoid arthritis: a retrospective single-center study

The objective of this study was to assess the characteristics of hospitalized patients suffering from tuberculosis with rheumatoid arthritis (RA), focusing specifically on those treated without anti-tumor necrosis factor (TNF) therapy.

We conducted a retrospective review to assess the characteristics of 1,022 hospitalized Japanese patients suffering from tuberculosis with and without RA between 2002 and 2011.

Compared with the 995 non-RA patients with tuberculosis, the 24 RA patients with tuberculosis treated without anti-TNF therapy were older and predominantly female. They less frequently had a history of smoking, with a higher rate of underlying respiratory diseases, an impaired performance status and side effects. The three RA patients receiving anti-TNF therapy had extrapulmonary tuberculosis; however, the rate of extrapulmonary tuberculosis in the other RA patients treated without anti-TNF therapy did not differ from that observed in the non-RA patients. Five patients died during hospitalization. The in-hospital mortality of the RA patients did not differ significantly from that of the non-RA patients. Independent factors contributing to in-hospital mortality did not include RA.

In this study, the RA patients treated without anti-TNF therapy did not differ from the non-RA patients in terms of the rate of extrapulmonary tuberculosis or bilateral pulmonary lesions, although they did exhibit a higher frequency of side effects of antituberculosis treatment. RA was not found to be an independent factor contributing to in-hospital mortality.