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P515. Efficacy of anti-TNF alpha therapy in patients receiving tuberculosis chemoprophylaxis

I. Gîrleanu1, A.-M. Singeap1, C. Cojocariu1, O. Stoica1, C. Sfarti1, A. Trifan1, 1University of Medicine and Pharmacy Gr. T. Popa, Gastroenterology, Iasi, Romania

Background

A major concern surrounding the use of tumor necrosis factor-alpha (TNF-alpha) inhibitors is their potential to increase the risk of opportunistic infections, particularly tuberculosis (TB), especially in countries with a high prevalence of TB like Romania. All patients with latent TB are receiving 6 months chemoprophylaxis with isoniazid. The aim of this study was to evaluate the efficacy of anti TNF alpha therapy in patients receiving TB chemoprophylaxis with isoniazid.

Methods

We conducted a prospective study of 37 patients with inflammatory bowel disease (IBD) who received anti TNF alpha therapy in the Department of Gastroenterology of a tertiary hospital, from Romania. Eleven patients diagnosed with IBD who received TB prophylaxis and anti TNF-alpha therapy were compared with a group of 26 patients treated with anti TNF-alpha only. All patients had a tuberculin skin test, a postero-anterior chest plain, and Quantiferon determination. When indicated treatment for latent TB was established – 6 months with isoniazid.

Results

Of 11 patients who fulfilled the criteria for chemoprophylaxis, none developed active TB after the beginning of anti-TNF-alpha therapy. Eight of these patients had received Infliximab and 3 patients Adalimumab. Remission rate was 72.8% in the first group and 73.6% in the second group. There was no difference in induction and maintaining the remission between the two groups (p = 0.554). There were no hepatic side effects in both groups.

Conclusion

TB chemoprophylaxis does not influence the efficacy of anti-TNF alpha therapy in patients with IBD.