抄録
The advent of anti-tumor necrosis factor (TNF)-α agents, specifically remedies for rheumatoid arthritis, sometimes make patients with rheumatoid arthritis go into remission. But, occasionally, it also brings an ancient scourge, tuberculosis. Japan is a country with a middle incidence rate of tuberculosis. So, it is important to make a vernacular solution suitable for tuberculosis-problems in Japan.
The problems concerning tuberculosis following therapy with anti-TNF-α agents in Japan as follows:
1. It is difficult to select RA patients infected with tuberculosis.
2. Prophylaxis of tuberculosis for the rheumatoid arthritis patients infected with tuberculosis is sometimes more difficult than usual.
3. Diagnosis of tuberculosis is more difficult than the usual because of the non-specific nature of tuberculosis following after the anti-TNF-α agents.
4. Tuberculosis following therapy with the agents may be refractory to anti-tuberculosis therapy.
5. Rheumatoid arthritis following the cessation of the agents may be refractory.
6. There are few good medical facilities to treat both tuberculosis and rheumatoid arthritis.
The most important lesson to be noted is stopping short at administration of anti-TNF-α agents when something is wrong or is expected is to happen.
