TNF blockers and tuberculosis: an Indian concern

Reactivation of latent tuberculosis (TB) with TNF blockers is a cause of concern particularly in developing countries like India, which has a high burden of TB infection. Although etanercept and infliximab are available in India, published data on Indian experience are scant. Limited data indicate that risk of reactivation of TB is substantially increased. With the growing use of these agents in India inspired by encouraging results in various rheumatic conditions a rise in cases of TB is expected. At present, no guidelines exist in India with regard to treatment of latent TB. Indian rheumatologists must adopt a rational approach when treating rheumatic diseases with TNF blockers.