TNF inhibitors increase the risk of nontuberculous mycobacteria in patients with seropositive rheumatoid arthritis in a mycobacterium tuberculosis endemic areaopen access
- Authors
- Park, Dong Won; Kim, Yun Jin; Sung, Yoon Kyoung; Chung, Sung Jun; Yeo, Yoomi; Park, Tai Sun; Lee, Hyun; Moon, Ji yong; Kim, Sang Heon; Kim, Tae Hyung; Yoon, Ho Joo; Sohn, Jang Won
- Issue Date
- Mar-2022
- Publisher
- Nature Research
- Citation
- Scientific Reports, v.12, no.1, pp.1 - 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- Scientific Reports
- Volume
- 12
- Number
- 1
- Start Page
- 1
- End Page
- 9
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/139327
- DOI
- 10.1038/s41598-022-07968-w
- ISSN
- 2045-2322
- Abstract
- The aim of this study is to examine the impact of tumor necrosis factor inhibitors (TNFI) on nontuberculous mycobacterium (NTM) infection in rheumatoid arthritis (RA) patients in a mycobacterium tuberculosis (MTB) endemic area. We selected 1089 TNFI-treated RA patients and 4356 untreated RA patients using propensity-matching analysis according to age, gender, and Charlson comorbidity index using the Korean National Health Insurance Service database from July 2009 to December 2010. Both groups were followed-up until the end of 2016 to measure the incidence of mycobacterial diseases. The incidence rate of NTM in TNFI-treated RA group was similar to those of MTB (328.1 and 340.9 per 100,000 person-years, respectively). The adjusted hazard ratio (aHR) of NTM for TNFI-treated RA compared to untreated RA was 1.751(95% CI 1.105–2.774). The risk of TNFI-associated NTM in RA was 2.108-fold higher among women than men. The age-stratified effects of TNFI on NTM development were significantly high in RA patients aged 50–65 years (aHR 2.018). RA patients without comorbidities had a higher incidence of NTM following TNFI treatment (aHR 1.742). This real-world, observational study highlights the need to increase awareness of NTM in TNFI-treated RA patients in an MTB endemic area.
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