Systemic sclerosis and the risk of tuberculosis

Shuo Ming Ou, Wen Chien Fan, Kun Ta Cho, Chiu Mei Yeh, Vincent Yi Fong Su, Man Hsin Hung, Yu Sheng Chang, Yi Jung Lee, Yung Tai Chen, Pei Wen Chao, Wu Chang Yang, Tzeng Ji Chen, Wei Shu Wang, Hsuan Ming Tsao, Li Fu Chen, Fa Yauh Lee, Chia Jen Liu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Pulmonary involvement is common in patients with systemic sclerosis (SSc), and this condition causes substantial morbidity and mortality. Disrupted immunity from the disease or associated medication may render such patients subject to tuberculosis (TB) infection. However, the relationship between SSc and TB has not yet been investigated. Methods: Using the Taiwan National Health Insurance Research Database, 838 patients with SSc diagnosed in Taiwan during 2000-2006 were identified and followed for emergence of TB infection. Incidence rate ratios (IRR) of TB compared to 8380 randomly selected age-, sex-, and comorbiditymatched controls without SSc were calculated. The Cox proportional hazards model was used for multivariate adjustment to identify independent risk factors for TB infection. Results: The risk of TB infection was higher in the SSc cohort than in controls (IRR 2.81, 95% CI 1.36-5.37; p = 0.004), particularly for pulmonary TB (IRR 2.53, 95% CI 1.08-5.30; p = 0.022). Other independent risk factors for TB infection in patients with SSc were age =≥ 60 years [hazard ratio (HR) 3.52, 95% CI 1.10-11.33; p = 0.035] and pulmonary hypertension (PH; HR 6.06, 95% CI 1.59-23.17; p = 0.008). Mortality did not differ for SSc patients with or without TB. Conclusion: In this nationwide study, the incidence of TB infection was significantly higher among patients with SSc than in controls without SSc. Special care should be taken in managing patients with SSc who are at high risk for TB, especially those aged = 60 years or who also have PH.

Original languageEnglish
Pages (from-to)1662-1669
Number of pages8
JournalJournal of Rheumatology
Volume41
Issue number8
DOIs
Publication statusPublished - 2014

Fingerprint

Systemic Scleroderma
Tuberculosis
Infection
Taiwan
Incidence
Mortality
National Health Programs
Pulmonary Tuberculosis
Proportional Hazards Models
Pulmonary Hypertension
Immunity
Cohort Studies
Databases
Morbidity
Lung

Keywords

  • Pulmonary fibrosis
  • Pulmonary hypertension
  • Systemic sclerosis
  • Tuberculosis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy
  • Medicine(all)

Cite this

Ou, S. M., Fan, W. C., Cho, K. T., Yeh, C. M., Su, V. Y. F., Hung, M. H., ... Liu, C. J. (2014). Systemic sclerosis and the risk of tuberculosis. Journal of Rheumatology, 41(8), 1662-1669. https://doi.org/10.3899/jrheum.131125

Systemic sclerosis and the risk of tuberculosis. / Ou, Shuo Ming; Fan, Wen Chien; Cho, Kun Ta; Yeh, Chiu Mei; Su, Vincent Yi Fong; Hung, Man Hsin; Chang, Yu Sheng; Lee, Yi Jung; Chen, Yung Tai; Chao, Pei Wen; Yang, Wu Chang; Chen, Tzeng Ji; Wang, Wei Shu; Tsao, Hsuan Ming; Chen, Li Fu; Lee, Fa Yauh; Liu, Chia Jen.

In: Journal of Rheumatology, Vol. 41, No. 8, 2014, p. 1662-1669.

Research output: Contribution to journalArticle

Ou, SM, Fan, WC, Cho, KT, Yeh, CM, Su, VYF, Hung, MH, Chang, YS, Lee, YJ, Chen, YT, Chao, PW, Yang, WC, Chen, TJ, Wang, WS, Tsao, HM, Chen, LF, Lee, FY & Liu, CJ 2014, 'Systemic sclerosis and the risk of tuberculosis', Journal of Rheumatology, vol. 41, no. 8, pp. 1662-1669. https://doi.org/10.3899/jrheum.131125
Ou SM, Fan WC, Cho KT, Yeh CM, Su VYF, Hung MH et al. Systemic sclerosis and the risk of tuberculosis. Journal of Rheumatology. 2014;41(8):1662-1669. https://doi.org/10.3899/jrheum.131125
Ou, Shuo Ming ; Fan, Wen Chien ; Cho, Kun Ta ; Yeh, Chiu Mei ; Su, Vincent Yi Fong ; Hung, Man Hsin ; Chang, Yu Sheng ; Lee, Yi Jung ; Chen, Yung Tai ; Chao, Pei Wen ; Yang, Wu Chang ; Chen, Tzeng Ji ; Wang, Wei Shu ; Tsao, Hsuan Ming ; Chen, Li Fu ; Lee, Fa Yauh ; Liu, Chia Jen. / Systemic sclerosis and the risk of tuberculosis. In: Journal of Rheumatology. 2014 ; Vol. 41, No. 8. pp. 1662-1669.
@article{7d4f72ef874d439a99d2af91c89b3ece,
title = "Systemic sclerosis and the risk of tuberculosis",
abstract = "Objective: Pulmonary involvement is common in patients with systemic sclerosis (SSc), and this condition causes substantial morbidity and mortality. Disrupted immunity from the disease or associated medication may render such patients subject to tuberculosis (TB) infection. However, the relationship between SSc and TB has not yet been investigated. Methods: Using the Taiwan National Health Insurance Research Database, 838 patients with SSc diagnosed in Taiwan during 2000-2006 were identified and followed for emergence of TB infection. Incidence rate ratios (IRR) of TB compared to 8380 randomly selected age-, sex-, and comorbiditymatched controls without SSc were calculated. The Cox proportional hazards model was used for multivariate adjustment to identify independent risk factors for TB infection. Results: The risk of TB infection was higher in the SSc cohort than in controls (IRR 2.81, 95{\%} CI 1.36-5.37; p = 0.004), particularly for pulmonary TB (IRR 2.53, 95{\%} CI 1.08-5.30; p = 0.022). Other independent risk factors for TB infection in patients with SSc were age =≥ 60 years [hazard ratio (HR) 3.52, 95{\%} CI 1.10-11.33; p = 0.035] and pulmonary hypertension (PH; HR 6.06, 95{\%} CI 1.59-23.17; p = 0.008). Mortality did not differ for SSc patients with or without TB. Conclusion: In this nationwide study, the incidence of TB infection was significantly higher among patients with SSc than in controls without SSc. Special care should be taken in managing patients with SSc who are at high risk for TB, especially those aged = 60 years or who also have PH.",
keywords = "Pulmonary fibrosis, Pulmonary hypertension, Systemic sclerosis, Tuberculosis",
author = "Ou, {Shuo Ming} and Fan, {Wen Chien} and Cho, {Kun Ta} and Yeh, {Chiu Mei} and Su, {Vincent Yi Fong} and Hung, {Man Hsin} and Chang, {Yu Sheng} and Lee, {Yi Jung} and Chen, {Yung Tai} and Chao, {Pei Wen} and Yang, {Wu Chang} and Chen, {Tzeng Ji} and Wang, {Wei Shu} and Tsao, {Hsuan Ming} and Chen, {Li Fu} and Lee, {Fa Yauh} and Liu, {Chia Jen}",
year = "2014",
doi = "10.3899/jrheum.131125",
language = "English",
volume = "41",
pages = "1662--1669",
journal = "Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "8",

}

TY - JOUR

T1 - Systemic sclerosis and the risk of tuberculosis

AU - Ou, Shuo Ming

AU - Fan, Wen Chien

AU - Cho, Kun Ta

AU - Yeh, Chiu Mei

AU - Su, Vincent Yi Fong

AU - Hung, Man Hsin

AU - Chang, Yu Sheng

AU - Lee, Yi Jung

AU - Chen, Yung Tai

AU - Chao, Pei Wen

AU - Yang, Wu Chang

AU - Chen, Tzeng Ji

AU - Wang, Wei Shu

AU - Tsao, Hsuan Ming

AU - Chen, Li Fu

AU - Lee, Fa Yauh

AU - Liu, Chia Jen

PY - 2014

Y1 - 2014

N2 - Objective: Pulmonary involvement is common in patients with systemic sclerosis (SSc), and this condition causes substantial morbidity and mortality. Disrupted immunity from the disease or associated medication may render such patients subject to tuberculosis (TB) infection. However, the relationship between SSc and TB has not yet been investigated. Methods: Using the Taiwan National Health Insurance Research Database, 838 patients with SSc diagnosed in Taiwan during 2000-2006 were identified and followed for emergence of TB infection. Incidence rate ratios (IRR) of TB compared to 8380 randomly selected age-, sex-, and comorbiditymatched controls without SSc were calculated. The Cox proportional hazards model was used for multivariate adjustment to identify independent risk factors for TB infection. Results: The risk of TB infection was higher in the SSc cohort than in controls (IRR 2.81, 95% CI 1.36-5.37; p = 0.004), particularly for pulmonary TB (IRR 2.53, 95% CI 1.08-5.30; p = 0.022). Other independent risk factors for TB infection in patients with SSc were age =≥ 60 years [hazard ratio (HR) 3.52, 95% CI 1.10-11.33; p = 0.035] and pulmonary hypertension (PH; HR 6.06, 95% CI 1.59-23.17; p = 0.008). Mortality did not differ for SSc patients with or without TB. Conclusion: In this nationwide study, the incidence of TB infection was significantly higher among patients with SSc than in controls without SSc. Special care should be taken in managing patients with SSc who are at high risk for TB, especially those aged = 60 years or who also have PH.

AB - Objective: Pulmonary involvement is common in patients with systemic sclerosis (SSc), and this condition causes substantial morbidity and mortality. Disrupted immunity from the disease or associated medication may render such patients subject to tuberculosis (TB) infection. However, the relationship between SSc and TB has not yet been investigated. Methods: Using the Taiwan National Health Insurance Research Database, 838 patients with SSc diagnosed in Taiwan during 2000-2006 were identified and followed for emergence of TB infection. Incidence rate ratios (IRR) of TB compared to 8380 randomly selected age-, sex-, and comorbiditymatched controls without SSc were calculated. The Cox proportional hazards model was used for multivariate adjustment to identify independent risk factors for TB infection. Results: The risk of TB infection was higher in the SSc cohort than in controls (IRR 2.81, 95% CI 1.36-5.37; p = 0.004), particularly for pulmonary TB (IRR 2.53, 95% CI 1.08-5.30; p = 0.022). Other independent risk factors for TB infection in patients with SSc were age =≥ 60 years [hazard ratio (HR) 3.52, 95% CI 1.10-11.33; p = 0.035] and pulmonary hypertension (PH; HR 6.06, 95% CI 1.59-23.17; p = 0.008). Mortality did not differ for SSc patients with or without TB. Conclusion: In this nationwide study, the incidence of TB infection was significantly higher among patients with SSc than in controls without SSc. Special care should be taken in managing patients with SSc who are at high risk for TB, especially those aged = 60 years or who also have PH.

KW - Pulmonary fibrosis

KW - Pulmonary hypertension

KW - Systemic sclerosis

KW - Tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=84905482184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905482184&partnerID=8YFLogxK

U2 - 10.3899/jrheum.131125

DO - 10.3899/jrheum.131125

M3 - Article

C2 - 25028380

AN - SCOPUS:84905482184

VL - 41

SP - 1662

EP - 1669

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 8

ER -