Bedfellows: mycobacteria and rheumatoid arthritis in the era of biologic therapy

Nat Rev Rheumatol. 2013 Sep;9(9):524-31. doi: 10.1038/nrrheum.2013.82. Epub 2013 Jun 25.


In modern times a relationship between tuberculosis (TB) and rheumatoid arthritis (RA) has been firmly recognized, and is primarily attributable to the immunosuppressive therapies used to treat RA. Whereas TB can complicate the successful management of RA, nontuberculous mycobacteria have now perhaps become as important as (if not more so than) TB in the setting of RA, and can represent an even greater challenge to the rheumatologist wishing to use immunosuppressive therapies. This article reviews our most recent understanding of the epidemiological and clinical aspects of mycobacterial disease as it relates to RA, and the existing and emerging immunosuppressive therapies used to treat this disease.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / epidemiology*
  • Biological Therapy*
  • Comorbidity
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Mycobacterium Infections / epidemiology*
  • Mycobacterium Infections, Nontuberculous / epidemiology*
  • Risk Factors
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors


  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha