• Abdullah Al-Sohaim, Abdullah Saleh Bawazir, Turki Al-Turki, Eiman Omar Alsafi, Abdullah Al-Roqy, Layla Layqah, and Salim Alawi Baharoone.
• From the Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2021 Sep 1; 41 (5): 285-292.

BackgroundAdalimumab is a fully humanized monoclonal antibody inhibitor of tumor necrosis factor-a used to treat various autoimmune disorders. Adalimumab poses a risk for tuberculosis (TB) infection, especially in countries where TB is endemic.ObjectiveDetermine the rate of TB infection after adalimumab therapy in Saudi Arabia.DesignMedical record review.SettingsTertiary care center in Riyadh.Patients And MethodsDemographic and clinical data were retrieved from the electronic healthcare records of all patients who received adalimumab treatment from 2015 to 2019.Main Outcome MeasuresOccurrence of TB after adalimumab therapy.Sample Size410 patients (median ([QR] age, 37 [28], range 4-81 years), 40% males RESULTS: Rheumatoid arthritis was the most frequent indication (n=153, 37%). The patients were followed for a mean of 36 (8.9) months. No case of TB infection or reactivation was observed. An inter-feron-gamma release assay (IGRA) was requested in 353/391 (90.3%) patients, prior to initiating therapy. The IGRA was positive in 26 cases (6.6%). The IGRA-positive patients received isoniazid prophylactically. Bacterial infectious complications of adalimumab therapy occurred in 12 (2.9%) patients. Urinary tract infection was the most frequent complication (culture requested in 48 patients, positive in 8).ConclusionAdalimumab treatment was not associated with a risk of TB disease or TB reactivation in our cohort over the follow-up observation period. No TB reactivation occurred with adalimumab therapy when TB prophylaxis was used. The positive IGRA rate in patients on adalimumab treatment was low (7%).LimitationsSingle center and one geographical area in Saudi Arabia.Conflict Of InterestNone.

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