Abstract
The risk of active tuberculosis (TB) in patients with dermatomyositis (DM) is poorly understood. The cohort study aimed to investigate the association between DM and the risk of active TB disease. We conducted a population based study on 4,958 patients with newly diagnosed DM and 19,832 matched controls according to age, sex, and index date between 1998 and 2008. The hazard ratios (HRs) and cumulative incidences of active TB disease between DM patients and controls were analyzed. During the study period, a total of 85 (1.7%) DM patients developed active TB disease, which was significantly higher than that of non-DM patients (0.64%). The incidence rate of active TB disease was higher among DM patients than controls (incidence rate ratio 2.95; 95% confidence interval [CI], 2.24 to 3.88). The Cox regression model demonstrated significantly higher active TB disease rate among DM patients compared with controls (adjusted HR, 2.64; 95% CI, 1.97 to 3.54; p < 0.001) after adjusting for age, sex, and underlying medical disorders. The most significant risk factors for developing active TB included male sex, diabetes mellitus comorbidity, and use of corticosteroids and azathioprine in DM patients. In conclusion, DM patients are at a greater risk for active TB disease.
Highlights
The risk of active tuberculosis (TB) in patients with dermatomyositis (DM) is poorly understood
Dermatomyositis (DM) is systemic autoimmune rheumatic disease characterized by chronic inflammation of the skeletal muscles, which is frequently accompanied by characteristic skin rashes
To evaluate the risk factors that are associated with the development of active TB disease in DM patients, a database acquired from the Taiwan National Health Research Institute (NHRI) was used to investigate the incidence and treatment modalities of DM patients who developed TB
Summary
The risk of active tuberculosis (TB) in patients with dermatomyositis (DM) is poorly understood. The Cox regression model demonstrated significantly higher active TB disease rate among DM patients compared with controls (adjusted HR, 2.64; 95% CI, 1.97 to 3.54; p < 0.001) after adjusting for age, sex, and underlying medical disorders. In DM patients, ten-year survival rates are reported to be widely variable, ranging from 53–91%1–3, and infection is considered one of the leading causes of mortality[1,2,4]. The association between the risk of active TB disease in patients with DM and the possible causative risk factors, comorbidities and medication effects remains unclear. To evaluate the risk factors that are associated with the development of active TB disease in DM patients, a database acquired from the Taiwan National Health Research Institute (NHRI) was used to investigate the incidence and treatment modalities of DM patients who developed TB
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