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 examination 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
  • Referral form via the Norwegian Public Health Institute
• Preventative treatment for Tbc (Isoniazid or Isoniazid in combination with rifampicin) should usually be terminated before treatment with TNF inhibitors starts, but sometimes together with antirheumatic 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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