Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: About 5% of the Brazilian population has some chronic inflammatory arthropathy (CIA), including rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PA) and juvenile idiopathic arthritis (JIA), and 30 to 50% of them will need to use some TNFα inhibitor to control disease activity. However, several studies have shown greater rates of active mycobacterial infections after starting of these medications. According Brazilian database, the incidence of active cases of mycobacterial infection, especially tuberculosis, has increased in patients with CIA when compared to the adult (86.93/100.000 persons-year vs. 37.48/100.000 P-Y, respectively) and pediatric Brazilian population (22.53/100.000 P-Y vs. 15.91/100.000 P-Y, respectively). It is worthy emphasizing that all of them were negative for latent tuberculosis infection (LTbI) in the first medical evaluation. Purpose: To compare clinical performance of 4 methods for detecting LTbI in CIA patients taking TNFα blockers.
Methods: A total of 87 patients were included in this cross-sectional study, of whom 35 with RA, 35 with AS, 7 with PA and 10 JIA patients. Patients with active tuberculosis, hepatitis B or C and HIV infection were excluded. All participants answered a specific questionnaire, including details on epidemiologic data, medical history, and symptoms related to tuberculosis, as well as BCG vaccine history and socioeconomic status. Besides, they performed chest radiography and tuberculin skin test (PPD). In case of induration lower than 4 mm, the test was repeated in the contralateral forearm up to 3 weeks after the first reading (PPD-Booster). The interferon gamma specific release assays (IGRAs) were performed using Elispot (T-SPOT.TB) and Quantiferon (Quantiferon-TB GOLD).
Results: Fourteen new cases of LTBI were identified in CIA adult patients taking TNFα inhibitors (Table 1). All JIA children were negative for the 4 tests. Although the concordance between the 4 tests has been above 75%, the positivity was not associated with active tuberculosis.
Conclusion: Fourteen new cases of LTBI were identified in CIA adult patients taking TNFα inhibitors (Table 1). All JIA children were negative for the 4 tests. Although the concordance between the 4 tests has been above 75%, the positivity was not associated with active tuberculosis. Table 1. Clinical performance of 4 methods for detecting LTBI in patients taking TNFα blockers
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Disclosure:
C. M. F. Gomes,
None;
M. T. Terreri,
None;
M. I. Pinto,
None;
K. Oseki,
None;
F. Spina,
None;
M. M. Pinheiro, None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-performance-of-4-methods-for-detecting-latent-tuberculosis-infection-ltbi-in-patients-with-active-chronic-inflammatory-arthritis-taking-tnf%ce%b1-blockers/