AB1274 RISK FACTORS FOR ACTIVE TUBERCULOSIS DURING FOLLOW-UP IN PATIENTS WITH RHEUMATIC IMMUNE DISEASE

Background

Rheumatic immune disease is a group of diseases caused by the strong immune response to self-antigens, leading to tissue and cell damage, affecting bone, joints, bursa, muscle and its surrounding soft tissues (tendons, ligaments and fascia). The risk of tuberculosis infection in rheumatic immune patients is 2 to 5 times ^[1-3] than that of the general population. Patients with rheumatic immune diseases require long-term treatment with glucocorticoids and immunosuppressants, and the risk of complicated tuberculosis infection significantly increases in ^[4]. When active tuberculosis infection occurs in rheumatic immune patients, quite a number of patients have atypical clinical manifestations, severe disease, difficult to cure, long infection time, high fatality rate, which seriously endanger people's health. Therefore, this study intends to explore the risk of active tuberculosis infection using immunosuppression agents and biological agents in patients with rheumatic immune diseases.

Objectives

The risk factors of active TB in rheumatic immune disease patients were explored.

Methods

The confirmed patients who went to the Rheumatology and Immunology Department of Xinjiang Uygur Autonomous Region from December 2014 to June 2015 were included. The clinical data and treatment plan were collected, followed up to December 2021 and the prognosis were collected. The risk factors of active tuberculosis were analyzed by K-M survival curve method.

Results

Data of 499 patients collected in this study, Including: In 213 cases of rheumatoid arthritis, In 79 cases of ankylosing spondylitis, In 84 cases of systemic lupus erythematosus, In 58 cases of Sjogren's syndrome, And 65 patients with other rheumatic diseases; Of them, 62 patients were lost to follow-up, Ten patients have died, Four patients were diagnosed with active TB infection when enrolled; Thus, 423 patients were included in the study, Among these, 109 males (25.8%), In 314 women (74.2%), Mean age was 48.2 ± 13.7 years, The mean follow-up was 80.2 ±7.7 months, Six cases of active tuberculosis (one case was bone tuberculosis, One case had a pleural tuberculosis, The remaining four cases were pulmonary tuberculosis).Survival analysis showed that patients with rheumatic immune diseases had an increased risk of using immunosuppressive agents compared with active TB infection (p=0.039) and an increased risk of using biologics compared with active TB infection (p=0.004). Multivariate COX regression analysis showed that the use of biologics was an independent risk factor in rheumatic immune disease patients with active TB (P=0.011).

Conclusion

Patients with rheumatic diseases have an increased risk of active TB using immunosuppressants or biologic agents,Use of biologic agents is an independent risk factor for the emergence of active TB.

References

[1]Liu X, et al. Prevalence and risk factors of active tuberculosis in patients with rheumatic diseases: a multi-center, cross-sectional study in China. Emerg Microbes Infect. 2021 Dec;10(1):2303-2312. [2]Yang Y, Thumboo J, Tan BH, et al. The risk of tuberculosis in SLE patients from an asian tertiary hospital. Rheumatol Int. 2017;37(6):1027–1033. [3]Torres-Gonzalez P, Romero-Diaz J, CerveraHernandez ME, et al. Tuberculosis and systemic lupus erythematosus: a case-control study in Mexico city. Clin Rheumatol. 2018;37(8):2095–2102. [4]Cheng CF, Huang YM, Lu CH, et al. Prednisolone dose during treatment of tuberculosis might be a risk factor for mortality in patients with systemic lupus erythematosus: a hospital-based cohort study. Lupus. 2019;28(14):1699–1704.

Acknowledgements:

NIL.

Disclosure of Interests

None Declared.