Rheumatoid Arthritis Significantly Increases Pulmonary TB Risk, Regardless of Treatment Status: Study Suggests
South Korea: In a large-scale, longitudinal study published in ERJ Open Research, researchers have found that individuals with rheumatoid arthritis (RA) remain significantly more vulnerable to active pulmonary tuberculosis (TB), even in clinical settings where TB screening is routinely conducted before initiating biologic therapies.
The research, led by Dr. Hayoung Choi from the Division of Pulmonary, Allergy, and Critical Care Medicine at Hallym University Kangnam Sacred Heart Hospital, underscores the continued need for vigilant TB surveillance in RA populations.
The nationwide study followed over 59,000 RA patients—subdivided into seropositive (SPRA) and seronegative (SNRA) groups—alongside nearly 298,000 matched controls without RA, over a period spanning up to nine years. Participants were tracked between 2010 and 2019, with a median follow-up duration of 4.4 years.
The key findings include the following:
- Individuals with rheumatoid arthritis (RA) had a 3.2-fold higher risk of developing active pulmonary tuberculosis (TB) compared to those without RA, even after adjusting for potential confounders.
- Seropositive RA patients exhibited a 3.2-fold increased TB risk compared to the general population.
- Seronegative RA patients showed a 2.5-fold higher risk of active pulmonary TB than matched controls.
- RA patients treated with biological or targeted synthetic DMARDs had a nearly 4.7-fold increased risk of developing active TB.
- RA patients not receiving these advanced therapies still had a 2.9-fold higher TB risk than the general population.
- The elevated TB risk in RA patients persisted regardless of exposure to DMARDs.
- Additional factors linked to increased TB susceptibility among RA patients included male sex, being underweight, and having comorbid conditions such as diabetes mellitus.
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