Risk of incident active tuberculosis disease in patients treated with non-steroidal anti-inflammatory drugs: a population-based study

BMC Pulmonary Medicine

Jiunn-Yih Wu¹  Chun-Wei Wu¹  Meng-Tse Gabriel Lee²  Chien-Chang Lee²  I-Lin Wu³  Yi-Wen Tsai⁴  Shy-Shin Chang⁵  Chih-Cheng Lai⁶ 

[1] Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan and Chang Gung University College of Medicine;Department of Emergency Medicine, National Taiwan University Hospital;Department of Emergency Medicine, Taoyuan Armed Forces General Hospital;Department of Family Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine;Department of Family Medicine, Taipei Medical University Hospital and School of Medicine, Taipei Medical University;Department of Intensive Care Medicine, Chi Mei Medical Center;

关键词: Tuberculosis;    NSAIDs;    Coxibs;   

DOI  :  10.1186/s12890-017-0425-3

来源: DOAJ

【 摘 要 】

Abstract Background Mycobacterium tuberculosis (TB) is one of the world’s most devastating public health threats. Our goal is to evaluate whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) affect the risk of new incident active TB disease. Methods We conducted a nested case-control analysis by using a 1 million longitudinally followed cohort, from Taiwan’s national health insurance research database. Effects of NSAIDs on active TB were estimated by conditional logistic regression and adjusted using a TB-specific disease risk score (DRS). NSAIDs exposures were defined as having a prescription record of NSAIDs ≧ 7 days that ended between 31 and 90 days prior to the index date. Results A total of 123,419 users of traditional NSAIDs, 16,392 users of cyclooxygenase-2 selective inhibitor (Coxibs), and 4706 incident cases of active TB were identified. Compared with nonusers, use of traditional NSAIDs was associated with an increased risk of TB in the unadjusted analysis ([RR], 1.39; 95% [CI], 1.24 – 1.57 and DRS adjusted analysis ([ARR], 1.30; 95% [CI], 1.15– 1.47). However, use of Coxibs was not associated with a significant increase in the risk of TB after DRS adjustment ([ARR], 1.23; 95% [CI], 0.89 – 1.70). Conclusions In this large population-based study, we found that subjects using traditional NSAIDs were associated with increased risk for active TB. We did not find evidence for a causative mechanism between traditional NSAIDs and TB, and more research is required to verify whether the association between traditional NSAIDs and TB is causal, or simply reflects an increased use of anti-inflammatory drugs in the early phases of TB onset.

【 授权许可】

Unknown