Session Information
Date: Tuesday, November 7, 2017
Title: Rheumatoid Arthritis – Clinical Aspects Poster III: Comorbidities
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose:
TNF-α inhibitors increase the risk of emergence of active tuberculosis (TB). Screening rheumatic patients for latent TB is a necessity before initiation of biological treatment. Population is vaccinated with BCG in Turkey and BCG vaccination decreases the specifity of tuberculin skin test (TST). QuantiFERON-TB Gold In-Tube Assay (QFT-GIT) is an option for latent TB screening in a BCG-vaccinated population. The aim of this study was to assess the factors affecting QFT-GIT test results before biological treatment.
Methods:
Hacettepe University Rheumatology Biologic Registry (HUR-BIO) is a single center biological registry since 2005. The study group is composed of patients registered in HUR-BIO. Only QFT-GIT is performed for latent TB screening before biological treatment since May 2011. Patients, who were screened with QFT-GIT for latent TB between May 2011 and August 2015, were included in the study. Demographical and clinical characteristics, QFT-GIT results of the patients were collected. Potential factors affecting QFT positivity were analyzed. Indeterminate results and diagnoses other than SpA and RA were excluded during the analysis.
Results:
1335 (58.2% female) patients were recruited. The mean age was 44.2 ± 12.9. Diagnoses were followed, 62.6 % SpA, 32.4 % RA, 5.0 % others. 94.2 % of patients declared that they had had BCG vaccination. QFT-GIT results were followed; 79.0 % negative, 19.3 % positive, 1.7 % indeterminate. On univariate analyses male gender (53.9% vs. 38.8%, p<0.001), mean age (50,6±12,4 vs. 42,8±12,5, p<0.001), ever-smoked (60.3% vs. 51.0%, p=0.008), diabetes mellitus (10.1% vs. 6.5%, p=0.05), educational level (high school, 47.3% vs. 57.5%, p=0.003), married patients (85.1% vs. 77.1%, p=0.005) and RA diagnosis (39.5% vs. 32.4%, p=0.032) were significantly higher in QFT-GIT positive group compared to the negative group. There was no difference between positive and negative groups in terms of BCG vaccination, neither steroid nor other immunosuppressant use. On multivariate logistic analysis for QFT-GIT positivity, age≥ 45 years and male gender were identified as independent factors with adjusted odd ratios of respectively 3.91 (95% CI 2.71-5.63, p<0.001) and 2.62 (95% CI 1,83-3,75, p<0.001).
Conclusion:
The risk of QFT-GIT positivity increases with male gender and older age among rheumatic patients. The fact that males participate social life more actively in Turkey and the increased possibility of encountering tuberculosis bacillus with age can explain this situation. The use of steroids, other immunosuppressive drugs and BCG status in the rheumatic patient group does not affect QFT-GIT results.
To cite this abstract in AMA style:
Seyhoglu E, Uyaroglu OA, Erden A, Kilic L, Armagan B, Sari A, Karadag O, Apras Bilgen S, Akdogan A, Ertenli I, Kalyoncu U, Kiraz S. Older Age and Male Gender Are Independent Predictors of Quantiferon Positivity Among Adult Rheumatic Patients in a Tertiary Care Center from a BCG Vaccinated Country: Hur-BIO Single Center Real Life Results [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/older-age-and-male-gender-are-independent-predictors-of-quantiferon-positivity-among-adult-rheumatic-patients-in-a-tertiary-care-center-from-a-bcg-vaccinated-country-hur-bio-single-center-real-life-r/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/older-age-and-male-gender-are-independent-predictors-of-quantiferon-positivity-among-adult-rheumatic-patients-in-a-tertiary-care-center-from-a-bcg-vaccinated-country-hur-bio-single-center-real-life-r/