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. 2015 Nov 17:5:16303.
doi: 10.1038/srep16303.

The increased risk of active tuberculosis disease in patients with dermatomyositis - a nationwide retrospective cohort study

Ping-Hsun Wu  1   2 , Yi-Ting Lin  3 , Yi-Hsin Yang  4 , Yu-Chih Lin  5 , Yi-Ching Lin  6   7   8
Affiliations

The increased risk of active tuberculosis disease in patients with dermatomyositis - a nationwide retrospective cohort study

Ping-Hsun Wu et al. Sci Rep. .

Abstract

The risk of active tuberculosis (TB) in patients with dermatomyositis (DM) is poorly understood. The cohort study aimed to investigate the association between DM and the risk of active TB disease. We conducted a population based study on 4,958 patients with newly diagnosed DM and 19,832 matched controls according to age, sex, and index date between 1998 and 2008. The hazard ratios (HRs) and cumulative incidences of active TB disease between DM patients and controls were analyzed. During the study period, a total of 85 (1.7%) DM patients developed active TB disease, which was significantly higher than that of non-DM patients (0.64%). The incidence rate of active TB disease was higher among DM patients than controls (incidence rate ratio 2.95; 95% confidence interval [CI], 2.24 to 3.88). The Cox regression model demonstrated significantly higher active TB disease rate among DM patients compared with controls (adjusted HR, 2.64; 95% CI, 1.97 to 3.54; p < 0.001) after adjusting for age, sex, and underlying medical disorders. The most significant risk factors for developing active TB included male sex, diabetes mellitus comorbidity, and use of corticosteroids and azathioprine in DM patients. In conclusion, DM patients are at a greater risk for active TB disease.

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Figures

Figure 1
Figure 1. Flow chart of participant recruitment in the National Health Insurance Database, Taiwan, 1998–2007.
Footnote: Non- dermatomyositis patients were enrolled from Longitudinal Health Insurance Database (LHID) 2005, which excluded all dermatomyositis diagnostic ICD-9 code (ICD-9CM 710.3). LHID was a cohort, which the National Health Research Institute of Taiwan randomly sampled a representative database of 1,000,000 subjects from the entire National Health Insurance enrollees. There were no statistically significant differences in age, gender, and health-care costs between the sample group and all enrollees.
Figure 2
Figure 2. Cumulative incidences of active tuberculosis disease estimated by the Kaplan–Meier approach in patients with and without dermatomyositis.
Dermatomyositis groups increased cumulative incidences of active tuberculosis disease than comparison groups (Log rank P < 0.001).
See this image and copyright information in PMC

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