Mycobacterium tuberculosis infection in patients with inflammatory bowel disease who received Anti-Tumor Necrosis Factor treatment in Russia

<b>Background:</b> Tumor necrosis factor-α antagonists (anti-TNF) are highly effective in treatment of patients with inflammatory bowel disease (IBD), however there is a known associated risk of developing Mycobacterium tuberculosis infection. The aim of research was to evaluate that risk by investigating for TB of IBD patients receiving the anti-TNF treatment. <b>Methods:</b> Between 2009-2018, in the prospective open observational single center study, 832 patients with IBD were screened prior to initiation of anti-TNF treatment. 446 (53.65%) of these received anti-TNF and were investigated during 626 courses of treatment (every 6 months and additionally in cases of any respiratory signs). Tuberculin skin test (TST), interferon-γ release assay (IGRA), and chest radiography or tomography were used for screening and evaluation of TB. <b>Results:</b> Of the 832 patients investigated during screening, chest radiography findings suggestive of past TB were detected in 27 (3.2%) patients and 25 (3.0%) patients had a prior history of TB. 777 (93.4%) were screened with TST and 29 (3.7%) of them had positive results. Preventive TB therapy received 36 (4.3%) patients before anti-TNF-α treatment, and 19 (4,3%) patients during the treatment. During the anti-TNF-α treatment 14 (3.1%) developed active TB. None of the patients who received the prophylactic therapy developed active TB. <b>Conclusions:</b> The study confirms the risk of developing TB infection in patients with IBD during treatment with anti-TNF. It is important to monitor patients not only prior to but also during the anti-TNF therapy for timely detection of TB.