Epidemiology of tuberculosis infection among Latin American patients with chronic inflammatory arthritis: data from the PANLAR registry of rheumatic diseases (PANRED)

Objectives To evaluate the screening, diagnosis, and treatment of tuberculosis infection (TBI), as well as the occurrence of tuberculosis disease (TBD), in patients with chronic inflammatory arthritis (CIA) at the initiation of disease-modifying antirheumatic drugs (DMARDs) and through 12 months of follow-up. Methods This real-life, prospective, multicenter, observational, study included patients classified as having rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) enrolled in the Pan-American League of Associations for Rheumatology (PANLAR) Registry of Rheumatic Diseases (PANRED). Data from 590 patients receiving targeted synthetic (ts), conventional synthetic (cs), or biologic (b) DMARDs were analyzed. Results Among the 590 participants, 460 (78.0%) were women, with a mean age of 52.4 ± 12.9 years. Overall, 353 (59.8%) were non-white, and 496 (84.1%) had RA. At baseline 321 (54.4%) were using glucocorticoids (GCs), 262 (44.4%) were receiving bDMARDs (mostly TNF inhibitors), 169 (28.6%) were on tsDMARDs, and 159 (26.9%) were on csDMARDs. TBI screening was performed in 430 patients (72.9%) at baseline, among whom 59 (13.7%) were diagnosed with TBI. At 12 months, 99 of the 430 patients who underwent baseline screening (23.0%) underwent repeat screening, which identified 5 new TBI cases. Two patients (0.34%) developed TBD. Conclusion Despite the high TBD burden in Latin America, a substantial proportion of patients with CIA did not undergo TBI screening prior to initiation of immunosuppressive therapy. The incidence of TBD during follow-up was 339/100,000 patient-years (95% CI: 41–1,224), reinforcing the need for appropriate screening strategies, periodic reassessment, and ongoing clinical surveillance during the use of different DMARDs.