Nontuberculous mycobacteria infections and anti-tumor necrosis factor-α therapy

Kevin L. Winthrop, Eric Chang, Shellie Yamashita, Michael F. Iademarco, Philip A. LoBue

Research output: Contribution to journalArticlepeer-review

238 Scopus citations


Patients receiving anti-tumor necrosis factor-α (anti-TNF-α) therapy are at increased risk for tuberculosis and other granulomatous diseases, but little is known about illness caused by nontuberculous mycobacteria (NTM) in this setting. We reviewed the US Food and Drug Administration MedWatch database for reports of NTM disease in patients receiving anti-TNF-α therapy. Of 239 reports collected, 105 (44%) met NTM disease criteria. Median age was 62 years; the majority of patients (66, 65%) were female, and most (73, 70%) had rheumatoid arthritis. NTM infections were associated with infliximab (n = 73), etanercept (n = 25), and adalimumab (n = 7); most patients were taking prednisone (n = 68, 65%) or methotrexate (n = 58, 55%) concurrently. Mycobacteria avium (n = 52, 50%) was most commonly implicated, and 9 patients (9%) had died at the time their infections were reported. A high rate of extrapulmonary manifestations (n = 46, 44%) was also reported.

Original languageEnglish (US)
Pages (from-to)1556-1561
Number of pages6
JournalEmerging infectious diseases
Issue number10
StatePublished - Oct 2009

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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