Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
Por:
Riestra, S, Taxonera, C, Zabana, Y, Carpio, D, Chaparro, M, Barrio, J, Rivero, M, Lopez-Sanroman, A, Esteve, M, de Francisco, R, Bastida, G, Garcia-Lopez, S, Manosa, M, Martin-Arranz, MD, Perez-Calle, JL, Guardiola, J, Munoz, F, Arranz, L, Cabriada, JL, Garcia-Sepulcre, MF, Navarro, M, Montoro-Huguet, MA, Ricart, E, Bermejo, F, Calvet, X, Piqueras, M, Garcia-Planella, E, Marquez, L, Minguez, M, Van Domselar, M, Bujanda, L, Aldeguer, X, Sicilia, B, Iglesias, E, Alcain, G, Perez-Martinez, I, Rolle, V, Castano-Garcia, A, Gisbert, JP, Domenech, E
Publicada:
1 jul 2022
Resumen:
(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-gamma-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18-20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50-0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66-0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20-22%] vs. 14% [95% CI 13-16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM.
Filiaciones:
Riestra, S:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Gastroenterol Dept, Oviedo 33011, Spain
Taxonera, C:
Hosp Clin Univ San Carlos, Inst Invest Hosp Clin San Carlos IdISSC, Gastroenterol Dept, Madrid 28040, Spain
Zabana, Y:
Hosp Univ Mutua Terrassa, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Terrassa 08221, Spain
Carpio, D:
Complexo Hosp Univ Pontevedra, Gastroenterol Dept, Pontevedra 36071, Spain
Chaparro, M:
Univ Autonoma Madrid UAM, Hosp Univ La Princesa,Gastroenterol Dept, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst Invest Sanitaria Princesa IIS IP, Madrid 28006, Spain
Barrio, J:
Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid 47012, Spain
Rivero, M:
Univ Cantabria, Hosp Univ Marques de Valdecilla, Inst Invest Sanitaria Valdecilla IDIVAL, Gastroenterol Dept, Santander 37008, Spain
Lopez-Sanroman, A:
Hosp Univ Ramon y Cajal, Gastroenterol Dept, Madrid 28034, Spain
Esteve, M:
Hosp Univ Mutua Terrassa, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Terrassa 08221, Spain
de Francisco, R:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Gastroenterol Dept, Oviedo 33011, Spain
Bastida, G:
Hosp Univ & Politecn La Fe, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Valencia 46026, Spain
Garcia-Lopez, S:
Hosp Univ Miguel Servet, Inst Invest Sanitaria Aragon IISA, Gastroenterol Dept, Zaragoza 50009, Spain
Manosa, M:
Hosp Univ Germans Trials i Pujol, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Badalona 08916, Spain
Martin-Arranz, MD:
Hosp Univ La Paz, Inst Invest Sanitaria, Gastroenterol Dept, Hosp La Paz IdiPAZ, Madrid 28046, Spain
Perez-Calle, JL:
Hosp Univ Fdn Alcorcon, Gastroenterol Dept, Madrid 28922, Spain
Guardiola, J:
Hosp Univ Bellvitge, Inst Invest Biomed Bellvitge IDIBELL, Gastroenterol Dept, Barcelona 08907, Spain
Munoz, F:
Hosp Univ Salamanca, Gastroenterol Dept, Salamanca 37007, Spain
Arranz, L:
Hosp Nuestra Setiora de la Candelaria, Gastroenterol Dept, Tenerife 38010, Spain
Cabriada, JL:
Hosp Galdakao Usansolo, Gastroenterol Dept, Galdakao 48960, Spain
Garcia-Sepulcre, MF:
Hosp Gen Univ Elche, Gastroenterol Dept, Alicante 03203, Spain
Navarro, M:
Hosp St Joan Desp Moises Broggi, Gastroenterol Dept, Barcelona 08970, Spain
Montoro-Huguet, MA:
Hosp San Jorge, Gastroenterol Dept, Huesca 22004, Spain
Ricart, E:
Hosp Clin Barcelona, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, IDIBAPS, Barcelona 08036, Spain
Bermejo, F:
Hosp Univ Fuenlabrada, Inst Invest Sanitaria Hosp La Paz IdiPaz, Gastroenterol Dept, Madrid 28942, Spain
Calvet, X:
Univ Autonoma Barcelona, Gastroenterol Dept, Hosp Univ Parc Tauli, Dept Med,Sabadell,CIBERehd, Sabadell 08208, Spain
Piqueras, M:
Consorcio Sanitario Terrasa, Gastroenterol Dept, Barcelona 08227, Spain
Garcia-Planella, E:
Hosp Santa Creu & Sant Pau, Gastroenterol Dept, Barcelona 08041, Spain
Marquez, L:
Hosp del Mar, Inst Hosp del Mar Invest Med, Gastroenterol Dept, Barcelona 08003, Spain
Minguez, M:
Hosp Clin Univ Valencia, Gastroenterol Dept, Valencia 46010, Spain
Van Domselar, M:
Hosp Univ Torrejon, Gastroenterol Dept, Madrid 28850, Spain
Bujanda, L:
Univ Pais Vasco UPV EHU, Hosp Univ Donostia Biodonostia, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, San Sebastin 20014, Spain
Aldeguer, X:
Hosp Univ Girona Dr Josep Trueta, Gastroenterol Dept, Girona 17007, Spain
Sicilia, B:
Hosp Univ Burgos, Gastroenterol Dept, Burgos 09006, Spain
Iglesias, E:
Hosp Reina Sofia, Gastroenterol Dept, IMIBIC, Cordoba 14004, Spain
Alcain, G:
Hosp Clin Malaga, Gastroenterol Dept, Malaga 29010, Spain
Perez-Martinez, I:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Gastroenterol Dept, Oviedo 33011, Spain
Rolle, V:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Gastroenterol Dept, Oviedo 33011, Spain
Castano-Garcia, A:
Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Gastroenterol Dept, Oviedo 33011, Spain
Gisbert, JP:
Univ Autonoma Madrid UAM, Hosp Univ La Princesa,Gastroenterol Dept, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst Invest Sanitaria Princesa IIS IP, Madrid 28006, Spain
Domenech, E:
Hosp Univ Germans Trials i Pujol, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Badalona 08916, Spain
Green Published, gold, All Open Access, Gold, Green
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