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TNF neutralisation therapy for inflammatory diseases strategies to prevent TB reactivation


TB REACT addresses a new risk of tuberculosis infection appeared in the last 5 years after introduction of a new treatment for chronic inflammatory diseases using therapeutic blockade of tumour necrosis factor (TNF).

Anti TNF therapies are invaluable in the management of rheumatoid arthritis and Crohn's disease, for which no other effective treatment exists (over 1 million patients already treated worldwide, indications expanding).

However anti TNF therapies have introduced a new threat with the recurrence of tuberculosis.Large multi center studies have reported hundreds of cases of atypical tuberculosis. In Spain, tuberculosis incidence increased by 50-90 fold in rheumatoid arthritis patients receiving anti TNF therapies as compared to the rest of the population.

This new emerging risk of tuberculosis recurrence under anti TNF treatment is likely to be due to reactivation of a latent, and most often undetectable, previous tuberculosis infection. All reviews on recurrent TB infections point to a lack of scientific understanding of TNF contribution in infection control.

We view TB REACT as a task force to systematically analyse the scientific roots of the new risk. Our goal is to develop in-depth scientific understanding of the role of the different molecular forms of TNF and TNF receptors in controlling tuberculosis infection and to propose candidate strategies for specific TNF neutralisation sparing the molecular forms essential for efficient control of tuberculosis. To this aim we will use a set of unique genetic models newly created by the expert and complementary partners of the project.

This data is highly relevant for robust decision making in designing safer, second generation anti TNF therapies for expanding inflammatory diseases.

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3 rue Michel Ange

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