Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: QuantiFERON-TB Gold is commercial interferon-γ release assay used to screen patients for tuberculosis before starting or while on immunosuppressive therapies. Clinical studies on efficacy of QuantiFERON-TB Gold testing show higher rates of indeterminate results among immunosuppressed populations compared to the general population. An indeterminate QuantiFERON-TB Gold result may preclude patients from starting certain therapies or enrolling in clinical trials. Hydroxychloroquine (HCQ) is proposed to reduce levels of interferon-γ and therefore may affect the results of a QuantiFERON-TB Gold test, however, its relationship to QuantiFERON-TB Gold results has not been studied
Methods: The medical records of 119 patients enrolled in prospective longitudinal databases for cutaneous lupus, dermatomyositis, and autoimmune blistering disease with QFT-G testing were reviewed. Patients were sorted into groups based on the presence or absence of HCQ use within one year of QuantiFERON-TB Gold testing. We also evaluated the concomitant use of prednisone and disease modifying anti-rheumatic drugs (DMARDs).
Results: In the study population of 119 patients, 46 were in the HCQ group, while 73 did not use HCQ in the year prior to testing. There were 24 (20%) indeterminate, 92 (77%) negative, and 3 (2.5%) positive QuantiFERON-TB Gold results total. The HCQ group had significantly more indeterminate QuantiFERON-TB Gold results (37%) compared to the non- HCQ group (9.6%) (p<0.001). There was no significant difference in concomitant use of prednisone or DMARDs (p=0.437, and p=0.085, respectively) between groups.
These results reveal that patients taking HCQ at the time of QuantiFERON-TB Gold testing are significantly more likely to have an indeterminate result compared to those not taking the medication, and this finding is not explained by concomitant use of prednisone or DMARDS. An indeterminate QuantiFERON-TB Gold result represents a major barrier to receiving treatment and therefore future studies are needed to evaluate the most appropriate tuberculosis screening in patients taking hydroxychloroquine.
To cite this abstract in AMA style:Gaffney R, Werth VP. Evaluating Results of an Interferon-γ Release Assay in Patients with Autoimmune Skin Disease on Hydroxychloroquine [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/evaluating-results-of-an-interferon-%ce%b3-release-assay-in-patients-with-autoimmune-skin-disease-on-hydroxychloroquine/. Accessed November 29, 2022.
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