{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:07:55Z","timestamp":1780376875650,"version":"3.54.1"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<sec><title>BACKGROUND<\/title>Biological therapies and Janus kinase (JAK) inhibitors have revolutionised the management of immune-mediated and oncologic diseases, but concerns remain regarding their potential to increase TB risk.<\/sec><sec><title>OBJECTIVE<\/title>To\n systematically synthesise evidence from previous systematic reviews on the risk of TB disease associated with different biological classes and JAK inhibitors.<\/sec><sec><title>METHODS<\/title>Following Preferred Reporting Items for Overviews of Reviews guidelines,\n we conducted an umbrella review of systematic reviews and meta-analyses, registered in PROSPERO (CRD42024497515). Twenty-five reviews met the inclusion criteria. Data were extracted on TB incidence, risk estimates, type, and time to onset. Risk of bias was assessed using ROBIS.<\/sec><sec><title>RESULTS<\/title>Anti-TNF\n monoclonal antibodies (infliximab, adalimumab) were consistently associated with the highest TB risk (odds ratio commonly 3\u20135), with greater proportions of disseminated\/extra-pulmonary disease compared to etanercept. Combination immunosuppression further increased risk. IL-6, IL-17,\n and IL-23 inhibitors showed low TB reactivation rates under screening and prophylaxis protocols. JAK inhibitors (notably tofacitinib) conferred geographically variable risk, higher in intermediate\/high-burden countries. Immune checkpoint inhibitors, especially PD-1\/PD-L1 agents, were linked\n to TB incidence far above background rates.<\/sec><sec><title>CONCLUSION<\/title>TB risk varies markedly across biologic and targeted agents. Risk-based TB infection screening and tailored prophylaxis beyond anti-TNF therapy are warranted, particularly in endemic\n regions.<\/sec><\/jats:p>","DOI":"10.5588\/ijtld.25.0518","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:31:26Z","timestamp":1780374686000},"page":"244-254","source":"Crossref","is-referenced-by-count":0,"title":["TB risk during treatment with biological agents and Janus kinase inhibitors: an umbrella review"],"prefix":"10.5588","volume":"30","author":[{"given":"R.F.","family":"Alves","sequence":"first","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Hil\u00e1rio","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Unidade Local de Sa\u00fade de Tr\u00e1s-os-Montes e Alto Douro, Vila Real, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.B.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Unidade Local de Sa\u00fade do T\u00e2mega e Sousa, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Cascais","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.P.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal;, EPIUnit ITR, Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, Universidade do Porto, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Vieira","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal;, EPIUnit ITR, Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, Universidade do Porto, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal;, EPIUnit ITR, Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, Universidade do Porto, Porto, Portugal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Duarte","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal;, EPIUnit ITR, Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, Universidade do Porto, Porto, Portugal;, Instituto Nacional de Sa\u00fade\n Doutor Ricardo Jorge (INSA-Porto), Porto, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2026\/00000030\/00000006\/art00002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:31:57Z","timestamp":1780374717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.25.0518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":0,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"alternative-id":["1027-3719(20260601)30:6L.244;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.25.0518","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}