Comparison of single and dual latent tuberculosis screening strategies before biologic and targeted therapy in patients with rheumatic diseases: a retrospective cohort study

Purpose: Before biologic and targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) treatment, latent tuberculosis infection (LTBI) screening by tuberculin skin test (TST) or interferon gamma release assay (IGRA) is recommended. However, both tests have reduced reliability in immunosupp...

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Published in:Hong Kong medical journal = Xianggang yi xue za zhi 2020-04, Vol.26 (2), p.111
Main Authors: Tang, Iris, Ho, So, Luk, Lucas, Wong, Victor, Pang, Steve, Lao, Virginia, Yip, Ronald
Format: Article
Language:chi ; eng
Subjects:
Agreements
Classification
Cohort analysis
Disease
Immunization
Patients
Psoriatic arthritis
Rheumatic diseases
Rheumatoid arthritis
Rheumatology
Survival analysis
Tuberculosis
Tumor necrosis factor-TNF
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Summary:Purpose: Before biologic and targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) treatment, latent tuberculosis infection (LTBI) screening by tuberculin skin test (TST) or interferon gamma release assay (IGRA) is recommended. However, both tests have reduced reliability in immunosuppressed patients. We investigated whether dual LTBI screening with both tests could reduce the incidence of tuberculosis. Methods: Consecutive patients receiving b/tsDMARDs for rheumatic diseases in a regional hospital were recruited. All patients underwent either TST/IGRA or both. They were categorised into a single or dual testing group and were followed up for at least 6 months. Isoniazid was prescribed if any one test was positive. Results: In total, 217 patients were included in this study; 121 underwent single LTBI testing and 96 underwent dual testing. Tuberculosis occurred in nine patients in the single testing group and one patient in the dual testing group (7.4% vs 1.0%, P=0.045). However, the difference w
ISSN:1024-2708
2226-8707
DOI:10.12809/hkmj198165