http://www.healthsentinel.com/news.p...rint_list_item
Jeanie Lerche Davis, "Tuberculosis Linked to Arthritis Drugs", Web MD,
August 5, 2004,
Link: http://my.webmd.com/content/article/...56-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.
