Are arthritis drugs causing a return of tuberculosis?
It’s a disease most of us never give a second thought to. It certainly doesn’t get the PR that comes with the little pink ribbon or the fear-mongering of measles.
But this killer looks like it’s about to make a comeback.
Less than 30 years ago, the federal government promised we were within reach of wiping tuberculosis out of America for good — a disease so dangerous it was once blamed for one of every seven deaths on the planet.
Now, though, new pockets of tuberculosis infections are popping up all over the country.
Researchers are looking everywhere for answers.
But the real culprit? Well, it may be in your medicine cabinet right now.
But public health researchers are paying plenty of attention to Marion these days — because right now, it has a tuberculosis rate higher than some Third World countries.
Twenty-six people — including four children — are now carrying the disease. Two have already died.
And Marion isn’t alone.
Even the CDC admits that for 2013-2014 (the last two years on record), America did a worse job controlling tuberculosis than at any point in the past decade.
During that time, there were 4,000 cases in California alone — and another 1,200 in Florida. And just this summer in El Paso, TX, another 70 people tested positive for the disease.
So why do we seem to be returning the days of the “Great White Plague?”
Well, believe it or not, there’s a popular class of drugs that can actually give you tuberculosis after just a handful of doses — and it may even turn you into a disease-spreading machine.
They’re called tumor necrosis factor (TNF) blockers, but you know them by their brand names like Enbrel, Humira, Remicade, Cimzia and Simponi. They’re supposed to control inflammation, which is why they’re prescribed for everything from arthritis to Crohn’s disease to psoriasis.
But trust me — they do a lot more than manage inflammation.
You see, about a third of people in the world — and around 15 million Americans — are carrying dormant tuberculosis bacteria in their bodies. It’s something called a latent tuberculosis infection (LTBI).
And the only thing that keeps this infection from running wild is that it’s trapped by a piece of inflamed tissue called a granuloma.
But these TNF blockers actually disrupt the granuloma and can allow the infection to escape.
In fact, that’s exactly what happened in the case of a 64-year-old woman with rheumatoid arthritis who developed tuberculosis after just seven treatments with Remicade — and a 55-year-old man who caught the disease after a year and a half on the drug.
Irish researchers started sounding the alarm years ago that TNF blockers could open a Pandora’s Box and create a “continued epidemic” of tuberculosis.
Now if you’ve seen a commercial for one of these TNF blockers, you’ve probably heard the announcer rattle off how they can cause tuberculosis and how you should be tested for a LTBI before starting them up.
Well, good luck with that.
Even the CDC warns that the LTBI test is badly flawed and can give a negative result even when there’s dormant bacteria hiding in your body.
Next stop, tuberculosis.
Listen, I don’t have to tell you that tuberculosis is nothing to fool with. Even if you beat it with antibiotics, it can cause lasting damage to your lungs.
And beating it is getting a lot harder, thanks to antibiotic-resistant strains of tuberculosis that are now floating around.
If you’re taking a TNF blocker, your safest bet is to talk to your doctor about alternatives — preferably ones that won’t breathe new life into one of history’s most dangerous diseases.
Sources:
“Tuberculosis kills 3, sickens 26 in Alabama” Fox News, January 8, 2016, foxnews.com
“TNF-blocking agents and tuberculosis: new drugs illuminate an old topic” J. Keane, Rheumatology, rheumatology.oxfordjournals.org
