- 作者：Fern ; o Bermejo ; Alicia Algaba ; Mar¨ªa Chaparro ; Carlos Taxonera ; Elena Garrido ; Isabel Garc¨ªa-Arata ; Iv¨¢n Guerra ; Javier P. Gisbert ; David Olivares ; Gema de-la-Poza ; Antonio L¨®pez-Sanrom¨¢n
- 关键词：Anti-tumour necrosis factor ; Inflammatory bowel disease ; Quantiferon ; Tuberculin skin test ; Tuberculosis
- 刊名：Digestive and Liver Disease
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：45
- 期：9
- 页码：733-737
- 全文大小：605 K
Background
Tuberculosis reactivation can lead to severe complications in patients treated with anti-tumour necrosis factor-alpha.Aim
To assess the usefulness of repeat tuberculosis screening tests in inflammatory bowel disease patients on stable anti-TNF therapy.
Methods
Cross-sectional study, in patients on prolonged anti-TNF treatment (¡Ý12 months) and basal negative screening for latent tuberculosis. Quantiferon?-TB Gold In-tube test was performed and then, tuberculin skin test was administered.
Results
74 patients were included, median duration of anti-TNF treatment was 30 months (IQR 19-54); 47 patients on infliximab and 27 on adalimumab; no patient was on glucocorticoids. Previous BCG vaccination was present in 5 cases. After anti-TNF was started, 4 patients suffered from potential tuberculosis exposure and two cases travelled to endemic areas. The cumulative incidence of tuberculin skin test conversion was 2.7 % (95 % CI 0.3-9.4 % , 2/74), and the incidence rate of tuberculin skin test conversion was 0.83 % (95 % CI 0.1-2.9 % ) per patient-year of treatment with anti-TNF drugs. All Quantiferon tests but one (a patient with an indeterminate result and a negative tuberculin skin test) were negative.
Conclusions
The incidence rate of conversion of tuberculosis screening tests among patients on anti-TNF treatment seems to be low and these conversions were diagnosed based on a positive tuberculin skin test and were discordant with Quantiferon testing.