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Tuberculosis Linked to Arthritis Drugs
Tuberculosis Linked to Arthritis Drugs -- Posted by Roman Bystrianyk on 10-18-04 18:26
http://www.healthsentinel.com/news.php?id=335&title=Tuberculosis+Linked+to+Arthritis+Drugs&event=news_print_list_item
Jeanie Lerche Davis, "Tuberculosis Linked to Arthritis Drugs", Web MD,
August 5, 2004,
Link: http://my.webmd.com/content/article/92/101599.htm?lastselectedguid=%7b5FE84E90-BC77-4056-A91C-953171
Several cases of tuberculosis (TB) have been linked to drugs commonly
prescribed for arthritis, the CDC reports.
Doctors who prescribe potent immune-suppressing drugs for their
rheumatoid arthritis patients should screen them for TB exposure and
infection before prescribing these drugs, the CDC says. Tuberculosis
is common in certain settings like jails, prisons, homeless shelters,
chronic-care facilities, and in some countries.
The arthritis drugs are all in a class called tumor necrosis
factor-alpha (TNF-a) antagonist drugs and include Remicade, Enbrel,
and Humira. These drugs work by blocking TNF-a, a chemical that
triggers inflammation. They are approved for treating rheumatoid
arthritis and other autoimmune diseases where inflammation is a key
component of the illness.
This same inflammatory chemical -- TNF-a -- is also associated with
certain infectious diseases like tuberculosis. Blocking this chemical
can allow a latent TB infection to emerge, says the CDC report.
Tuberculosis is caused by bacteria that mainly attack the lungs. Often
the body can fight a TB infection, but the bacteria remain dormant in
the body.
TNF-a blocker medications suppress the immune system and can allow the
bacteria to re-emerge and cause tuberculosis. This is called a latent
infection.
New Cases Pop Up
In 2002, three cases of tuberculosis occurred in people taking
Remicade. Nine more cases have been reported in California. According
to the CDC's report, most of the reported cases are latent infections.
Details on the infected people:
* The average age is 55, and 67% are female.
* Fever, cough, weight loss, and enlarged lymph nodes are initial
symptoms.
* Eleven developed tuberculosis after receiving Remicade.
* Eleven of the patients had been in countries where tuberculosis is
common or had contact with someone infected with tuberculosis.
* Eight were taking other medications that suppressed the immune
system.
A few of the case studies:
A U.S.-born, 55-year-old man with rheumatoid arthritis was diagnosed
with tuberculosis within 17 months of starting Remicade. Although his
arthritis had improved, he developed fever, lost weight, and developed
an enlarged lymph node. He then had a chest X-ray, which showed
evidence of TB. He was treated with medications but has since died of
lung cancer (he was a longtime smoker).
The second case involved a 64-year-old woman with rheumatoid
arthritis; she was diagnosed with tuberculosis just 10 months after
starting Remicade. Her symptoms were fever and weight loss. After 12
months of medication, her medical condition has improved.
A third case involved a U.S.-born, 54-year-old woman with Crohn's
disease. She was exposed to tuberculosis in 1996 and had a positive
skin test for TB. She developed cough, fever, and stomach pains after
Remicade infusions in 2001. Her chest X-ray revealed tuberculosis. She
tried taking a standard, four-drug TB therapy but developed stomach
problems from it. Other tuberculosis drug treatments, however, worked.
Re: Tuberculosis Linked to Arthritis Drugs -- Posted by Kitty Kelly on 10-19-04 16:18
This has been known for several years. My RD made all his patient's get
TB tests before they were put on the a-TNF's.
The problem they're having is why are patient's not at risk for TB and
that previously tested negative for it, suddenly developing it. It's
supposed to be a human to human transmissible disease and yet they have
a core group of people who seem to have spontaneously developed it.
-g-
Kitty
Re: Tuberculosis Linked to Arthritis Drugs -- Posted by Tuck on 11-01-04 07:59
On Tue, 19 Oct 2004 16:18:06 -0700, KittyQOTU@webtv.net (Kitty Kelly)
wrote:
>This has been known for several years. My RD made all his patient's get
>TB tests before they were put on the a-TNF's.
>
>The problem they're having is why are patient's not at risk for TB and
>that previously tested negative for it, suddenly developing it. It's
>supposed to be a human to human transmissible disease and yet they have
>a core group of people who seem to have spontaneously developed it.
>
Not really.
There is a growing epidemic of TB in the US. Since the symptoms are
vague and easy to dismiss (by both doctors and patients) it goes
undiagnosed for YEARS. And spreads happily along the way.
With the growing number of uninsured people who only see the doctor
when they are close to dead the vectors are already here. You see
them every day, at the grocery, serving your food in restaurants, as
cashiers at Walmart, etc...
Bet that if they went and TB tested all of the "casual contacts" they
find at least one and probably more active cases.
Proof that you can't take your money and go hide from all those nasty
bacteria.
Barbara
Re: Tuberculosis Linked to Arthritis Drugs -- Posted by blades on 11-01-04 08:30
I think that prisoners are a source of TB infection as are some illegal
immigrants. Russian prisons bred a version of TB that doesn't respond
to any known single antibiotic. TB is around. Take precautions.
--
Bruce
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