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The use of biologics has transformed the treatment paradigm for <jats:styled-content style=\"fixed-case\">RD<\/jats:styled-content>; however, biologic treatment\u2010related infections (especially tuberculosis [<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>]) are an area of potential concern for <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010endemic nations like India. Anti\u2010tumor necrosis factor (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) therapy impairs the physiological <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010mediated signaling and may cause reactivation and dissemination of latent <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> infection (<jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content>). Careful screening is, thus, crucial in <jats:styled-content style=\"fixed-case\">RD<\/jats:styled-content> patients who are about to commence anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> treatment. To date, there is no consensus available for the screening, evaluation and treatment of <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> as well as on the drug dosage and duration regimen (monotherapy or combination therapy) in the Indian population. An evidence\u2010based algorithm for <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> screening and management in <jats:styled-content style=\"fixed-case\">RD<\/jats:styled-content> patients undergoing biologic disease\u2010modifying anti\u2010rheumatic drug therapy is suggested in this review for Indian rheumatologists. The proposed algorithm guides physicians through a step\u2010wise screening approach, including medical history, tuberculin skin test, interferon gamma release assay, chest radiograph and management of <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> with isoniazid therapy or its combination with rifampicin. Further, the provided algorithm can aid the national bodies (such as National <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> Control Program) in formulating recommendations for <jats:styled-content style=\"fixed-case\">LTBI<\/jats:styled-content> in this high\u2010risk population.<\/jats:p>","DOI":"10.1111\/1756-185x.13129","type":"journal-article","created":{"date-parts":[[2017,7,21]],"date-time":"2017-07-21T08:20:40Z","timestamp":1500625240000},"page":"1313-1325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Tuberculosis and biologics in rheumatology: A special situation"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-4170","authenticated-orcid":false,"given":"Rohini","family":"Handa","sequence":"first","affiliation":[{"name":"Department of Rheumatology Indraprastha Apollo Hospital New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundeep","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Indraprastha Apollo Hospital New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Indian Spinal Injuries Center New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Jois","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Fortis Hospital Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bimlesh D.","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Fortis Hospital Noida India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuj K.","family":"Bhatnagar","sequence":"additional","affiliation":[{"name":"Rajan Babu Institute of Pulmonary Medicine and Tuberculosis  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwani","family":"Khanna","sequence":"additional","affiliation":[{"name":"State TB Control Department New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Goyal","sequence":"additional","affiliation":[{"name":"Medical Affairs Department Janssen India Johnson &amp; Johnson Pvt. 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