Risk of incident active tuberculosis disease in patients treated with non-steroidal anti-inflammatory drugs: A population-based study
Journal
BMC Pulmonary Medicine
Journal Volume
17
Journal Issue
1
Pages
82
Date Issued
2017
Author(s)
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. ? 2017 The Author(s).
SDGs
Other Subjects
cyclooxygenase 2 inhibitor; dexibuprofen; diclofenac; etodolac; ibuprofen; ketoprofen; meloxicam; nabumetone; naproxen; nonsteroid antiinflammatory agent; piroxicam; tolfenamic acid; cyclooxygenase 2 inhibitor; nonsteroid antiinflammatory agent; adult; aged; Article; case control study; cohort analysis; controlled study; drug use; female; human; longitudinal study; major clinical study; male; patient risk; population research; prescription; Taiwan; tuberculosis; comparative study; factual database; middle aged; multivariate analysis; public health; risk factor; statistical model; time factor; tuberculosis; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Case-Control Studies; Cyclooxygenase 2 Inhibitors; Databases, Factual; Female; Humans; Logistic Models; Longitudinal Studies; Male; Middle Aged; Multivariate Analysis; National Health Programs; Risk Factors; Taiwan; Time Factors; Tuberculosis
Type
journal article