Definition

TNF inhibitors, several other types Biological drugs og Janus Kinase (JAK) inhibitors Is shown to decrease the immune system So latent Tuberculosis (Tbc) (bacteria from previous infection) may flare up. Corresponding risk is also available when using high doses of corticosteroids (Prednisone, SoluMedrol and others). IGRA test (Blood test) is central to detect latent Tbc.

Prior to treatment with TNF inhibitors

• Targeted disease history on Tbc
• Complete clinical examination
• X-ray of the lungs or CT (computer tomography) of the lungs
• Tuberculin test or IGRA test
• Refer to a specialist in lung diseases or infectious diseases if
  • Previously known Tbc exposure in the family or circle
  • Previous or current positive tuberculin reaction or IGRA test
  • Earlier treated for Tbc
  • Abnormal findings in X-ray examination of lungs
  • Form for referral via the Norwegian “National Institute of Public Health”
• Preventative treatment for Tbc (Isoniazid or Isoniazid in combination with rifampicin) should usually be stopped before starting treatment with a TNF-antagonist, but is sometimes given with the anti-rheumatic treatment
• Preventative treatment is no guarantee of later tuberculosis

 Symptoms of Tbc

• Reduced general condition
• Weight Loss
• Fever
• Night sweats
• Reap
• Hemoptysis (bloody cough)
• Dyspnea (heavy breathing)
• Lymphnodes are swollen
• See also about Tbc here (Bindevevsykdommer.no)

Source: The Norwegian Public Health Institute

Medications, BINDEVEVSSYKDOMMER.no

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