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Tuberculosis Screenings Urged for Psoriasis Patients

Immunologic therapy should be delayed in patients who test positive for latent tuberculosis

THURSDAY, July 24 (HealthDay News) -- Before psoriasis patients are treated with systemic and biologic agents, they should be screened and treated for latent tuberculosis infections, according to a National Psoriasis Foundation consensus statement published in the August issue of the Journal of the American Academy of Dermatology.

Sean D. Doherty, M.D., of the Baylor College of Medicine in Houston, and colleagues conducted a literature review of immunosuppressive therapies and the risk of tuberculosis.

The researchers agreed that tumor necrosis factor-alpha (TNF-α) inhibitors are promising psoriasis treatments. But they cautioned that TNF-α plays a key role in preventing new tuberculosis infections and keeping latent infections from becoming active. They also cited evidence showing that the use of TNF-α inhibitors and other immunosuppressive/immunomodulatory treatments is associated with an increased risk of active tuberculosis in psoriasis patients.

"It is, therefore, of utmost importance to appropriately screen all patients for latent tuberculosis infection before initiating any immunologic therapy," the authors conclude. "Delaying immunologic therapy until latent tuberculosis infection prophylaxis is completed is preferable. However, if the patient is adhering to his prophylactic regimen and is appropriately tolerating the regimen, therapy may be started after one to two months if the clinical condition requires."

Several of the study co-authors disclosed financial ties to pharmaceutical companies.

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