Mycobacterial Infections Potentiated by Biologics

Infect Dis Clin North Am. 2020 Jun;34(2):413-423. doi: 10.1016/j.idc.2020.02.011.

Abstract

Biologic therapies have revolutionized the treatment of immune-mediated inflammatory diseases but are associated with an increased risk of serious and opportunistic infections, including tuberculosis and nontuberculous mycobacterial disease. Despite this increased risk, the overall risk-benefit ratio remains favorable with appropriate screening and risk assessment. Further population-based studies are needed to establish the risk of tuberculosis and nontuberculous mycobacterial disease with the new biologics. This article highlights the incidence and drug-specific risk of tuberculous and nontuberculous mycobacterial infection in the setting of biologics, screening and prevention, and treatment of latent tuberculosis in this setting.

Keywords: Biologics; Mycobacteria; Opportunistic infection; Tuberculosis.

Publication types

  • Review

MeSH terms

  • Biological Products / adverse effects*
  • Endemic Diseases
  • Humans
  • Mycobacterium Infections, Nontuberculous / chemically induced
  • Mycobacterium Infections, Nontuberculous / epidemiology
  • Nontuberculous Mycobacteria
  • Tuberculosis / chemically induced*
  • Tuberculosis / epidemiology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • United States / epidemiology

Substances

  • Biological Products
  • Tumor Necrosis Factor-alpha