Fortes FML, Rocha R, Santana GO. Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients. World J Gastroenterol 2023; 29(9): 1536-1538 [PMID: 36998430 DOI: 10.3748/wjg.v29.i9.1536]
Corresponding Author of This Article
Raquel Rocha, DSc, Adjunct Associate Professor, Ciência da Nutrição, Universidade Federal da Bahia, Av Araujo Pinho, Salvador 40110160, Brazil. raquelrocha2@yahoo.com.br
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 7, 2023; 29(9): 1536-1538 Published online Mar 7, 2023. doi: 10.3748/wjg.v29.i9.1536
Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients
Flora Maria Lorenzo Fortes, Raquel Rocha, Genoile Oliveira Santana
Flora Maria Lorenzo Fortes, Genoile Oliveira Santana, Ciências da Vida, Universidade do Estado da Bahia, Salvador 41150000, Brazil, and Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110060, Brazil
Raquel Rocha, Ciência da Nutrição, Universidade Federal da Bahia, Salvador 40110160, Brazil
Author contributions: Fortes FML designed the study and performed the data analysis; Rocha R reviewed the manuscript and provided technical and material support; and Santana GO contributed to the study design, manuscript revision, supervision of the study, had full access to all of the data in the study and was responsible for the integrity of the data.
Conflict-of-interest statement: Genoile O Santana is on the Advisory Board for Janssen; has received speaking fees from Abbvie, Ferring, Janssen, Takeda, Pfizer and UCB Pharma; and has received research grants from Janssen, Lilly, Pfizer, Roche and Takeda. The other authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raquel Rocha, DSc, Adjunct Associate Professor, Ciência da Nutrição, Universidade Federal da Bahia, Av Araujo Pinho, Salvador 40110160, Brazil. raquelrocha2@yahoo.com.br
Received: November 21, 2022 Peer-review started: November 21, 2022 First decision: December 10, 2022 Revised: January 5, 2023 Accepted: February 22, 2023 Article in press: February 22, 2023 Published online: March 7, 2023
Abstract
The use of thiopurines is an independent risk factor for active tuberculosis in patients with inflammatory bowel disease.
Core Tip: Inflammatory bowel disease (IBD) patients recommended for anti-tumor necrosis factor (anti-TNF) therapy need to be tested for latent tuberculosis (TB) prior to treatment. Azathioprine monotherapy is also an independent risk factor for active TB in patients with IBD. However, the recommendations of the Brazilian Public Health Guideline for Tuberculosis Prevention do not include patients who are receiving immunosuppressive therapy in the risk group for screening for latent TB. We evaluated 301 patients with IBD, and the use of azathioprine treatment increased the risk by 6.87-fold compared to patients without this treatment. The use of anti-TNF therapy had a 10.34-fold increased risk of TB, and the combination of both increased the risk by 17.81-fold.
