ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1942

Prevalence and Screening Strategy for Latent Tuberculosis Infection in Patients with Rheumatic Immune-Mediated Diseases

Carmen Lasa1, Joy Selene Osorio2, David Martínez-Lopez3, Carmen Alvarez Reguera4, Virginia Portilla5, Jose Cifrian6, Ivan Ferraz Amaro7 and Ricardo Blanco2, 1Hospital Universitario Marqués de Valdecilla, IDIVAL., La Cavada, Spain, 2Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 3Hospital Sierrallana, Torrelavega, Spain, 4Hospital Universitario Marqués de Valdecilla, Santander, Spain, 5Rheumatology Department, Immunopathology Group, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain, 6Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL; Department of Pneumology, Marqués de Valdecilla University Hospital; School of Medicine, Cantabria University, Santander, Spain, 7Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain

Meeting: ACR Convergence 2023

Keywords:

Session Information

Date: Tuesday, November 14, 2023

Title: (1913–1944) Miscellaneous Rheumatic & Inflammatory Diseases Poster III

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Patients with rheumatic immune-mediated inflammatory diseases (rheumatic-IMID) with latent tuberculosis infection (LTBI) requiring biologic therapy (BT) are at anincreased risk of developing active tuberculosis (TB). Screening of LTBI with tuberculin skin test (TST) and/or interferon (IFN)-γ release assays (IGRA) is recommended before startingBT.

Methods: Cross-sectional single University hospital study including all patients diagnosedwith rheumatic-IMID who underwent a TST test and/or IGRA in a five-year period (2016-2020). TST was performed by a subcutaneous injection of 0.1 ml of purified proteinderivative (PPD) with a reading after 72 hours. TST was considered positive with aninduration of more than 5 mm of diameter. If the first TST was negative, a new TST (booster)was performed between 1 and 2 weeks after the first TST. The IGRA test used wasQuantiFERON®-TB Gold Plus (QFT-Plus). LTBI was diagnosed by a positive IGRA and/orTST and absence of active TB (normal chest X-ray). Concordance between IGRA and TSTwas studied using adjusted Cohen’s kappa coefficient.

Results: Booster was positive in 66 patients (7.7%) out of 857 patients with a negative simple TST.TST (+ booster) was positive in 187 patients (22.9%) out of 817 with a negative orindeterminate IGRA test. IGRA test was positive in 30 (3.8%) out of 793 patients with anegative TST (+ booster), as is shown in Figure 1 and 2. Adjusted Cohen’s Kappa coefficient between TST (+ booster) andIGRA (QFT-plus) was 0.62.

Conclusion: LTBI is frequent between patients with rheumatic-IMID. Booster after negativesimple TST may be useful, since it can detect LTBI. Furthermore, IGRA and TST (+ booster)show a moderate fair grade of agreement. In addition, some patients who had a negative orindeterminate result on IGRA or TST could have a positive result in the other examination.This highlights the importance of performing both tests in all patients. Accordingly,performing both tests in patients with rheumatic-IMID before BT may be highlyrecommended.

Supporting image 1

Supporting image 2

Disclosures: C. Lasa: None; J. Osorio: None; D. Martínez-Lopez: None; C. Alvarez Reguera: None; V. Portilla: None; J. Cifrian: None; I. Ferraz Amaro: AbbVie/Abbott, 5, 6, Amgen, 5, 6, Bristol-Myers Squibb(BMS), 6; R. Blanco: AbbVie, 5, 6, Amgen, 6, AstraZeneca, 2, BMS, 6, Eli Lilly, 6, Galapagos, 2, 6, Janssen, 2, 6, MSD, 6, Novartis, 2, 6, Pfizer, 2, 6, Roche, 5, 6, Sanofi, 6.

To cite this abstract in AMA style:

Lasa C, Osorio J, Martínez-Lopez D, Alvarez Reguera C, Portilla V, Cifrian J, Ferraz Amaro I, Blanco R. Prevalence and Screening Strategy for Latent Tuberculosis Infection in Patients with Rheumatic Immune-Mediated Diseases [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/prevalence-and-screening-strategy-for-latent-tuberculosis-infection-in-patients-with-rheumatic-immune-mediated-diseases/. Accessed .

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