Tuberculin skin test before biologic and targeted therapies: does the same rule apply for all?

İlgen U., KARADAĞ Ö., EMMUNGİL H., KÜÇÜKŞAHİN O., Koca S. S., Erden A., ...Daha Fazla

Rheumatology International, cilt.42, sa.10, ss.1797-1806, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 42 Sayı: 10
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s00296-022-05134-z
  • Dergi Adı: Rheumatology International
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.1797-1806
  • Anahtar Kelimeler: Arthritis, Spondyloarthritis, Interferon-gamma release tests, Tuberculin test, Latent tuberculosis, GAMMA RELEASE ASSAYS, CLINICAL-PRACTICE GUIDELINES, QUANTIFERON-TB-GOLD, LATENT TUBERCULOSIS, RHEUMATOID-ARTHRITIS, CLASSIFICATION CRITERIA, ACTIVE TUBERCULOSIS, ITALIAN SOCIETY, DISEASE-CONTROL, INFECTION
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.This study aimed to compare Tuberculin Skin Test (TST) and QuantiFERON®-TB Gold In-Tube (QFT–GIT) test in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients scheduled for biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) in a Bacillus Calmette-Guérin-vaccinated population. Adult RA (n = 206) and SpA (n = 392) patients from the TReasure database who had both TST and QFT–GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT–GIT were compared between RA and SpA groups. Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cutoff (p < 0.001). Only 8.9% and 15% of the patients with RA and SpA, respectively, tested positive by QFT–GIT. The two tests poorly agreed in both groups at a TST cutoff of 5 mm and increasing the TST cutoff only slightly increased the agreement. Among age, sex, education and smoking status, pre-biologic steroid and conventional DMARD use, disease group, and QFT–GIT positivity, which were associated with a 5 mm or higher TST, only disease group (SpA) and QFT–GIT positivity remained significant in multiple logistic regression. TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT–GIT was poor in both groups. Using a 5 mm TST cutoff for both diseases could result in overestimating LTBI in SpA.