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Home / Ask the Expert / RA treatment and positive TB test

RA treatment and positive TB test

January 28, 2009 By Arthritis Center

Question

I am 49 and was diagnosed with RA 2 months ago. I have been on MTX for 8 weeks. I have not seen any improvement and have read that it can take even up to 3 months for MTX to work. I have also read that taking a combination of etanercept and MTX is more effective than just MTX. In 2002 I had a positive PPD test but went to a pulmonary specialist with X rays to determine if it was active. It was not. I have had x rays every year to 18 months since 2002. Is it too risky for me to take etanercept since I had a positive PPD test in 2002?

Answer

Hi Marybeth,

A positive PPD is concerning and should be treated if one is going to receive Enbrel or any of the other biologic drugs for RA.  Enbrel is a little less problematic than Humira and Remicade but it is still a risk.  It doesn’t matter if the chest xray doesn’t show any evidence of past TB because the PPD indicates past exposure, and that exposure could be in the liver or some other organ, not just the lungs. 

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