drugs and TB? | Arthritis Information

When I went to the Rd Tue. They had two large signs to make sure everyone would see them, that warned if you are on any of these drugs that you need to take a TB test once a month. Thank God our Meds. were not on it. I just wondered if any of you have heard this warning. Some time the drugs cause more problems then the ra. I would be curious to know what those drugs are?

When i was going to take hemira, they told me i would have to take tb tests every year, not sure how many times, but had to take one just to be able to have it.

Many drugs like biologics can cause TB, have also been known to cause cancer and other problems.

I keep getting told by doctors that if it were up to them, they would take prednisone only since new stuff comes out daily to fix the arthritis rpoblems it causes.

There is bad with the good. I guess you just pray daily and hope you aren't one that comes out with one.

Antirheumatic Drugs and the Risk of Tuberculosis
Paul Brassard,1,2,3 Abbas Kezouh,3 and Samy Suissa1,2,3
Departments of 1Medicine and 2Epidemiology and Biostatistics, McGill
University, and 3Division of Clinical Epidemiology, Royal Victoria Hospital,
McGill University Health Centre, Montreal, Canada
Received 19 January 2006; accepted 28 May 2006; electronically
published 10 August 2006.

Reprints or correspondence: Dr. Paul Brassard, Div. of Clinical
Epidemiology, Royal Victoria Hospital, 687 Pine Ave. West, Ross 4.29,
Montreal, Québec, Canada H3A 1A1 (paul.brassard@mcgill.ca).
Background. We aimed to quantify the rate of Mycobacterium
tuberculosis disease (TB) among a cohort of patients with rheumatoid
arthritis (RA) and to assess whether the independent use of disease‐
modifying antirheumatic drugs (DMARDs) is associated with the risk of
developing TB.

Methods. The study was performed using the PharMetrics Patient‐Centric
database (PharMetrics). The cohort consisted of all subjects with 1
occurrence of a diagnosis of RA during an inpatient or outpatient visit
during the period of September 1998 through December 2003.
Conditional logistic regression was used in a nested case‐control analysis
to estimate the rate ratio (RR) of TB with any use of biological or
traditional DMARDs during the year before the index date. We also
assessed the interaction between DMARDs and the current use of
corticosteroids.

Results. The cohort consisted of 112,300 patients with RA. A total of 386
cases of TB were identified, which resulted in an overall rate of 2.19 cases
per 1000 person‐years. The adjusted RR of TB for biological DMARD use is
1.5 (95% CI, 1.1–1.9). Use of traditional DMARDs was also independently
associated with TB (RR, 1.2; 95% CI, 1.0–1.5). RRs of developing TB
disease with the use of biological or traditional DMARD were lower among
current users of corticosteroids than among noncurrent users of
corticosteroids.

Conclusion. We found that the use of biological and traditional DMARDs
is associated with an increased risk of developing TB in patients with RA,
mainly among noncurrent users of corticosteroids.

I had a positive ppd skin test as a child which means I was exposed to TB without actually developing it. Had to have a chest X-ray which showed nothing.

When RA came along at age 53, one of the treatments I had to undergo was 6 months of a drug called INH that suppresses the tendency or predisposition to TB that the positive ppd thing all those years ago revealed in me. I'm now about to go from mtx onto Enbrel and there was some discussion about needing another course of INH but the decision has been made that it is not needed.

So - I don't think it's true that RA 'causes' TB, but if there is a predisposition to it for whatever reason, some of the RA drugs are KNOWN to reactivate the TB.