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New Biologic Therapies and the Risk of Tuberculosis in Older People

Richard Long, MD, Professor, Department of Medicine, University of Alberta, Edmonton, AB; Chairman, Tuberculosis Committee, Canadian Thoracic Society.

The incidence of tuberculosis increases with age in Canadians. The prevalence of latent tuberculosis infection (LTBI) may also increase with age in Canadians, though information on the age distribution of LTBI is less precise. Chronic inflammatory conditions that currently constitute the major indications for new biologic therapies (tumour necrosis factor inhibitors), such as Crohn's disease and rheumatoid arthritis, often have an older age onset. Biologic therapies have the potential to cause LTBI to progress to active tuberculosis disease. Their use in older Canadians or other populations that may have a higher than average prevalence of LTBI poses a challenge to tuberculosis control.
Key words: tuberculosis, tumour necrosis factor inhibitors, age, rheumatoid arthritis, Crohn's disease.