Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country
Abstract Objectives: To evaluate, in an endemic country, the long-term efficacy of latent tuberculosis infection (LTBI) screening and primary prophylaxis in patients with JIA receiving TNF blockers. Methods: This was a retrospective cohort that included JIA patients eligible to anti-TNF therapy. Patients were screened for LTBI prior to anti-TNF using tuberculin skin test (TST), chest X-ray and history of exposure to TB. Subjects were regularly followed at 2-month intervals. Results: Sixty-nine JIA patients with current age of 17.4 ± 5.8 years, mean disease duration of 5.0 ± 4.9 years were included. Forty-seven patients received a single anti-TNF, while 22 patients switched to another anti-TNF once or twice: 57 were treated with etanercepte, 33 patients with adalimumab and 3 infliximab. LTBI screening was positive in three patients: one had TST-positive and history of TB exposure and two had solely TST-positive. No active TB was diagnosed during the study period (median of follow-up was 3.8 years). Conclusion: Long-term evaluation revealed that LTBI screening and primary prophylaxis before anti-TNF treatment was effective in a high-risk country and TST was the most sensitive parameter to identify these patients.
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Sociedade Brasileira de Reumatologia
2017
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oai:scielo:S0482-500420170005003922017-11-21Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk countryBrunelli,Juliana BarbosaBonfiglioli,Karina RossiSilva,Clovis A.Kozu,Katia TomieGoldenstein-Schainberg,ClaudiaBonfa,EloisaAikawa,Nadia Emi Juvenile idiopathic arthritis Tuberculosis Isoniazid Mantoux Anti-TNF Abstract Objectives: To evaluate, in an endemic country, the long-term efficacy of latent tuberculosis infection (LTBI) screening and primary prophylaxis in patients with JIA receiving TNF blockers. Methods: This was a retrospective cohort that included JIA patients eligible to anti-TNF therapy. Patients were screened for LTBI prior to anti-TNF using tuberculin skin test (TST), chest X-ray and history of exposure to TB. Subjects were regularly followed at 2-month intervals. Results: Sixty-nine JIA patients with current age of 17.4 ± 5.8 years, mean disease duration of 5.0 ± 4.9 years were included. Forty-seven patients received a single anti-TNF, while 22 patients switched to another anti-TNF once or twice: 57 were treated with etanercepte, 33 patients with adalimumab and 3 infliximab. LTBI screening was positive in three patients: one had TST-positive and history of TB exposure and two had solely TST-positive. No active TB was diagnosed during the study period (median of follow-up was 3.8 years). Conclusion: Long-term evaluation revealed that LTBI screening and primary prophylaxis before anti-TNF treatment was effective in a high-risk country and TST was the most sensitive parameter to identify these patients.info:eu-repo/semantics/openAccessSociedade Brasileira de ReumatologiaRevista Brasileira de Reumatologia v.57 n.5 20172017-10-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042017000500392en10.1016/j.rbre.2016.11.004 |
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Brunelli,Juliana Barbosa Bonfiglioli,Karina Rossi Silva,Clovis A. Kozu,Katia Tomie Goldenstein-Schainberg,Claudia Bonfa,Eloisa Aikawa,Nadia Emi |
| spellingShingle |
Brunelli,Juliana Barbosa Bonfiglioli,Karina Rossi Silva,Clovis A. Kozu,Katia Tomie Goldenstein-Schainberg,Claudia Bonfa,Eloisa Aikawa,Nadia Emi Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country |
| author_facet |
Brunelli,Juliana Barbosa Bonfiglioli,Karina Rossi Silva,Clovis A. Kozu,Katia Tomie Goldenstein-Schainberg,Claudia Bonfa,Eloisa Aikawa,Nadia Emi |
| author_sort |
Brunelli,Juliana Barbosa |
| title |
Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country |
| title_short |
Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country |
| title_full |
Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country |
| title_fullStr |
Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country |
| title_full_unstemmed |
Latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-TNF therapy in a tuberculosis high-risk country |
| title_sort |
latent tuberculosis infection screening in juvenile idiopathic arthritis patients preceding anti-tnf therapy in a tuberculosis high-risk country |
| description |
Abstract Objectives: To evaluate, in an endemic country, the long-term efficacy of latent tuberculosis infection (LTBI) screening and primary prophylaxis in patients with JIA receiving TNF blockers. Methods: This was a retrospective cohort that included JIA patients eligible to anti-TNF therapy. Patients were screened for LTBI prior to anti-TNF using tuberculin skin test (TST), chest X-ray and history of exposure to TB. Subjects were regularly followed at 2-month intervals. Results: Sixty-nine JIA patients with current age of 17.4 ± 5.8 years, mean disease duration of 5.0 ± 4.9 years were included. Forty-seven patients received a single anti-TNF, while 22 patients switched to another anti-TNF once or twice: 57 were treated with etanercepte, 33 patients with adalimumab and 3 infliximab. LTBI screening was positive in three patients: one had TST-positive and history of TB exposure and two had solely TST-positive. No active TB was diagnosed during the study period (median of follow-up was 3.8 years). Conclusion: Long-term evaluation revealed that LTBI screening and primary prophylaxis before anti-TNF treatment was effective in a high-risk country and TST was the most sensitive parameter to identify these patients. |
| publisher |
Sociedade Brasileira de Reumatologia |
| publishDate |
2017 |
| url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042017000500392 |
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