Tuberculosis reactivation following apremilast therapy for psoriasis: Time to consider routine TB screening?

Apremilast is a relatively new oral treatment for psoriasis, which reduces expression of pro‐inflammatory factors, including tumour necrosis factor‐α (TNFα), critical to the immune control of Mycobacterium tuberculosis infection. In randomised controlled trials (RCTs) for apremilast no new cases of...

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Bibliographic Details
Published in:Australasian journal of dermatology 2024-12, Vol.65 (8), p.e255-e258
Main Authors: Adams, Lucinda, Smith, Emma L., Tilakaratne, Dev, Krause, Vicki
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
biologic therapy
Clinical trials
Humans
infectious diseases
Latent Tuberculosis - chemically induced
Latent Tuberculosis - diagnosis
Latent Tuberculosis - drug therapy
mycobacterial infection
Mycobacterium tuberculosis - isolation & purification
Psoriasis
Psoriasis - drug therapy
Risk assessment
Thalidomide - adverse effects
Thalidomide - analogs & derivatives
Thalidomide - therapeutic use
Tuberculosis
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Summary:Apremilast is a relatively new oral treatment for psoriasis, which reduces expression of pro‐inflammatory factors, including tumour necrosis factor‐α (TNFα), critical to the immune control of Mycobacterium tuberculosis infection. In randomised controlled trials (RCTs) for apremilast no new cases of active tuberculosis (TB) were identified, thus, screening for latent TB infection (LTBI) is not currently recommended prior to apremilast initiation. We describe a case of M.tuberculosis reactivation shortly after commencement of apremilast for psoriasis. We are recommending clinicians perform LTBI risk assessment in all patients, and appropriate LTBI screening in select populations prior to apremilast initiation.
ISSN:0004-8380
1440-0960
1440-0960
DOI:10.1111/ajd.14364