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Vol. 109. Num. 7.September 2018
Pages e1-e10Pages 577-666
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Vol. 109. Num. 7.September 2018
Pages e1-e10Pages 577-666
Special article
DOI: 10.1016/j.adengl.2018.06.020
Prevention and treatment of tuberculosis infection in candidates for biologic therapy: A multidisciplinary consensus statement adapted to the dermatology patient
Consenso multidisciplinar sobre prevención y tratamiento de la tuberculosis en pacientes candidatos a tratamiento biológico. Adaptación al paciente dermatológico
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P. Rodríguez-Jiméneza,
Corresponding author
, I. Mir-Viladrichb, P. Chicharroa, G. Solano-Lópeza, F.J. López-Longoc, C. Taxonerad, P. Sánchez-Martíneze, X. Martínez-Lacasaf, M. García-Gasallag, J. Dorcah, M. Arias-Guilléni, J.M. García-Garcíaj, E. Daudena
a Servicio de Dermatología, IIS-FIB, Hospital Universitario de La Princesa. Madrid, España
b Servicio de Neumología, Hospital Son Llàtzer, Palma de Mallorca, España
c Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, España
d Servicio del Aparato Digestivo, Hospital Clínico San Carlos e Instituto de Investigación del Hospital Clínico San Carlos (IdISSC), Madrid, España
e Servicio de Enfermedades Infecciosas, Hospital del Mar, Barcelona, España
f Unidad Control de Tuberculosis, Hospital Universitari Mutua de Terrassa, Barcelona, España
g Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España
h Servicio de Neumología, Hospital Universitario de Bellvitge, Hospitalet de Llobregat (Barcelona), España
i Servicio de Neumología, Hospital Universitario Central de Asturias-Instituto Nacional de Silicosis, Oviedo, España
j Servicio de Neumología, Hospital San Agustín, Avilés, España
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Tables (8)
Table 1. Degree of Recommendation18
Table 2. Type of Biological Agent, Indication, and Date of Approval.
Table 3. Immunosuppressants That May Induce Tuberculosis.
Table 4. Incidence and Relative Risk of Tuberculosis in Rheumatoid Arthritis Before and After Introduction of Anti-TNF Agents: Impact of the Recommendations.
Table 5. Groups at High Risk of Conversion to Active Tuberculosis.
Table 6. Results of Screening Tests for Latent Tuberculosis Infection in Patients with Systemic Inflammatory Diseases.
Table 7. Interpretation of the Results of Screening in Immunosuppressed Patients.
Table 8. Final Recommendations with Degree of Evidence.
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Abstract

Patients with chronic inflammatory diseases being treated with immunosuppressive drugs, and with tumor necrosis factor inhibitors in particular, have an increased risk of infection by Mycobacterium tuberculosis. Screening for latent tuberculosis infection and preventive therapy to reduce the risk of progression to active tuberculosis are mandatory in this group of patients. This updated multidisciplinary consensus document presents the latest expert opinions on the treatment and prevention of tuberculosis in candidates for biologic therapy and establishes recommendations based on current knowledge relating to the use of biologic agents.

Keywords:
Psoriasis
Hidradenitis suppurativa
Biologic therapy
Tuberculosis
Consensus
Resumen

El riesgo de infección por Mycobacterium tuberculosis se halla aumentado en los pacientes con enfermedades inflamatorias crónicas y en tratamiento inmunosupresor, en particular con terapia antifactor de necrosis tumoral α. La detección de la infección tuberculosa latente y el tratamiento preventivo dirigido a reducir el riesgo de progresión a tuberculosis activa es obligatoria en este grupo de pacientes. Este documento de consenso multidisciplinar actualiza la opinión de expertos y establece recomendaciones para el diagnóstico y tratamiento de la infección tuberculosa latente en estos pacientes, según los conocimientos actuales en terapias biológicas.

Palabras clave:
Psoriasis
Hidrosadenitis supurativa
Terapias biológicas
Tuberculosis
Consenso

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