For how long do you recommend treatment for latent tuberculosis prior to initiation of anti-TNF therapy?
Answer from: at Academic Institution
Some recommendations call for completing a course of treatment for latent TB prior to starting a biologic but I find most patients and referring specialists are intolerant of that strategy. This reference: Yeo et al., European Respiratory Journal 2014 is a good example of data supporting a shor...
Additionally, one should consider the clinical urgency for initiating anti-TNF therapy (Fehily et al., PMID 35596242). When possible, delaying treatment for at least one month is recommended. If there is no clinical urgency, the treatment can be postponed till the completion of therapy. If it is an ...
Comments
at Uniformed Services University of the Health Sciences (USUHS) Thanks for this additional reference! Patients wit...
at UTMB Health Agree with Dr. @Thomas.
at Beebe Infectious Disease Dr. @Mandadi does make a great point. Many people ...
Agree with all these answers. To provide a source, waiting one month after initiation of latent TB treatment before initiating a biologic or JAK inhibitor is the formal recommendation of the latest ACR RA Treatment Guidelines (Singh et al., PMID 26545825).
Comments
at Hill Physicians According to UpToDate, “We prefer a delay of...
at Uniformed Services University of the Health Sciences (USUHS) @Roger Wang, I completely understand the confusion...
at Hill Physicians Really appreciate your insightful and thought-prov...
I don’t think it’s that straightforward. If it’s a recent LTBI, then the risk of evolving to active TB is much higher as opposed to someone who has been positive for years (like myself who converted after working in a TB hospital in the 1970s). Some may also have positive tests aft...