{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:58:26Z","timestamp":1773251906612,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to investigate the frequency and clinical characteristics of tuberculosis in pediatric patients receiving both anti\u2010TNF\u2010alpha and other biological agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>The data of 270 patients who used biological agents due to rheumatologic diseases and inflammatory bowel disease (IBD) and were followed between January 2021 and October 2023 were retrospectively collected from their files.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the patients, 138(51.1%) were female, 132(48.9%) were male. The mean age at diagnosis was 107\u2009months (min 8\u2013max 215\u2009months). Patients were most commonly followed for juvenile idiopathic arthritis (JIA) (191 patients, 70.7%), followed by other autoinflammatory diseases (49 patients) and IBD (26 patients, 9.6%). Treatments included adalimumab (97 patients, 35.9%), etanercept (85 patients, 31.5%), canakinumab (33 patients, 12.2%), tocilizumab (31 patients, 11.5%), infliximab (16 patients, 5.9%), anakinra (5 patients, 1.9%), tofacitinib (2 patients, 0.7%), and rituximab (1 patient, 0.4%). During follow\u2010up, latent tuberculosis infection (LTBI) developed in 5 (1.9%) patients. Three of these patients had JIA (using adalimumab, etanercept and tocilizumab), one had Familial Mediterranean Fever (using canakinumab), and one had IBD (using adalimumab). The mean duration of biological agent treatment until LTBI development was 14.6\u2009months (min 6\u2013max 29\u2009months). Tuberculosis disease was diagnosed in two patients. Both were patients followed up due to IBD. One of the patients was diagnosed with miliary tuberculosis after infliximab treatment, while the other was followed for tuberculosis lymphadenitis after adalimumab treatment. Quadruple anti\u2010tuberculosis therapy was initiated for the patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of biological agents has revolutionized the course of chronic inflammatory diseases in childhood. However, in these patients, monitoring for tuberculosis risk is crucial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.70145","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T04:40:48Z","timestamp":1740544848000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Balancing Effective Treatments With Potential Threats: The Impact of Biologic Agent Use on Tuberculosis Development in Children With Chronic Inflammatory Disorders"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2989-6480","authenticated-orcid":false,"given":"Ayse Hitay","family":"Telefon","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Diseases Ministry of Health Adana City Training &amp; Research Hospital: TC Saglik Bakanligi Adana Sehir Egitim ve Arastirma Hastanesi  Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0924-5739","authenticated-orcid":false,"given":"Merve Kilic","family":"Cil","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases Ministry of Health Adana City Training &amp; 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