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Title: Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
Author: Riestra, Sabino
Taxonera, Carlos
Zabana, Yamile
Carpio, Daniel
Chaparro, María
Barrio, Jesús
Rivero, Montserrat
López Sanroman, Antonio
Esteve, María
Francisco, Ruth de
Bastida, Guillermo
García López, Santiago
Mañosa, Miriam
Martin Arranz, María Dolores
Pérez Calle, José Lázaro
Guardiola, Jordi
Muñoz, Fernando
Arranz, Laura
Cabriada, José Luis
García Sepulcre, Mariana Fe
Navarro, Mercè
Montoro Huguet, Miguel Ángel
Ricart, Elena
Bermejo, Fernando
Calvet, Xavier
Piqueras, Marta
Garcia Planella, Esther
Márquez, Lucía
Mínguez, Miguel
Van Domselar, Manuel
Bujanda, Luis
Aldeguer, Xavier
Sicilia, Beatriz
Iglesias, Eva
Alcaín, Guillermo
Pérez Martínez, Isabel
Rolle, Valeria
Castaño García, Andrés
Gisbert, Javier P.
Domènech, Eugeni
The ENEIDA Registry From GETECCU
Keywords: Malalties inflamatòries intestinals
Inflammatory bowel diseases
Issue Date: 5-Jul-2022
Publisher: MDPI AG
Abstract: (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.
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It is part of: Journal of Clinical Medicine, 2022, vol. 11, num. 13, p. 3915
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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