Is tremfya safe for people with latent tuberculosis?

Is tremfya safe for people with latent tuberculosis?

Tremfya is a monoclonal antibody targeting IL-23 and used for plaque psoriasis and psoriatic arthritis. It increases susceptibility to infections by suppressing immune activity, especially in patients who already host silent infections.

Tremfya should not be started until latent tuberculosis is treated. Guidelines require tuberculosis screening before therapy begins. Screening detects hidden cases that can reactivate under immunosuppression.

Tremfya has no contraindication for resolved or treated latent tuberculosis. Patients who received adequate treatment for latent tuberculosis before receiving Tremfya have shown no higher risk of active disease than patients without tuberculosis exposure.

Why does latent tuberculosis require screening before any IL-23 inhibitor?

IL-23 blockade weakens a key pathway that keeps M. tuberculosis contained in granulomas. This can allow bacteria to exit the stumm, exit the still-quiescent state, and move into active disease.

What happens if latent tuberculosis is detected during screening?

If latent tuberculosis is detected, physicians must treat it first. Treatment usually lasts four months with isoniazid and rifapentine, or nine months with isoniazid alone. Treatment clears the hidden bacteria before the patient receives Tremfya.