Nontuberculous Mycobacteria Infections and Anti-Tumor Necrosis Factor-α Therapy
Nontuberculous Mycobacteria Infections and Anti-Tumor Necrosis Factor-α Therapy
复制标题
DOI：
10.3201/eid1510.090310
复制
发表时间：
2009-10-01
影响因子：
11.8
通讯作者：
LoBue, Philip A.
中科院分区：
文献类型：
--
作者：
Winthrop, Kevin L.;Chang, Eric;LoBue, Philip A.
接受抗肿瘤坏死因子-α（抗TNF-α）治疗的患者患结核病和其他肉芽肿性疾病的风险增加，但对这种情况下由非结核分枝杆菌（NTM）引起的疾病知之甚少。我们回顾了美国食品和药物管理局MedWatch数据库中接受抗TNF-α治疗的患者中NTM疾病的报告。在收集的239份报告中，105份（44%）符合NTM疾病标准。中位年龄为62岁;大多数患者（66，65%）为女性，大多数（73，70%）患有类风湿性关节炎。NTM感染与英夫利西单抗（n = 73）、依那西普（n = 25）和阿达木单抗（n = 7）相关;大多数患者同时服用泼尼松（n = 68，65%）或甲氨蝶呤（n = 58，55%）。鸟分枝杆菌（n = 52，50%）最常见，9例患者（9%）在报告感染时死亡。还报告了肺外表现的高发生率（n = 46，44%）。
Patients receiving anti-tumor necrosis factor-alpha (anti-TNF-alpha) therapy are at increased risk for tuberculosis and other granulomatous diseases, but little is known about illness caused by nontuberculous mycobacteria (NTM) in this setting. We reviewed the US Food and Drug Administration MedWatch database for reports of NTM disease in patients receiving anti-TNF-alpha therapy. Of 239 reports collected, 105 (44%) met NTM disease criteria. Median age was 62 years; the majority of patients (66, 65%) were female, and most (73, 70%) had rheumatoid arthritis. NTM infections were associated with infliximab (n = 73), etanercept (n = 25), and adalimumab (n = 7); most patients were taking prednisone (n = 68, 65%) or methotrexate (n = 58, 55%) concurrently. Mycobacteria avium (n = 52, 50%) was most commonly implicated, and 9 patients (9%) had died at the time their infections were reported. A high rate of extrapulmonary manifestations (n = 46, 44%) was also reported.