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Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different...

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Autores principales: Riestra, Sabino, Taxonera, Carlos, Zabana, Yamile, Carpio, Daniel, Chaparro, María, Barrio, Jesús, Rivero, Montserrat, López-Sanroman, Antonio, Esteve, María, de Francisco, Ruth, Bastida, Guillermo, García-López, Santiago, Mañosa, Miriam, Martin-Arranz, María Dolores, Pérez-Calle, José Lázaro, Guardiola, Jordi, Muñoz, Fernando, Arranz, Laura, Cabriada, José Luis, García-Sepulcre, Mariana Fe, Navarro, Mercè, Montoro-Huguet, Miguel Ángel, Ricart, Elena, Bermejo, Fernando, Calvet, Xavier, Piqueras, Marta, Garcia-Planella, Esther, Márquez, Lucía, Mínguez, Miguel, Van Domselar, Manuel, Bujanda, Luis, Aldeguer, Xavier, Sicilia, Beatriz, Iglesias, Eva, Alcaín, Guillermo, Pérez-Martínez, Isabel, Rolle, Valeria, Castaño-García, Andrés, P. Gisbert, Javier, Domènech, Eugeni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267853/
https://www.ncbi.nlm.nih.gov/pubmed/35807201
http://dx.doi.org/10.3390/jcm11133915
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author Riestra, Sabino
Taxonera, Carlos
Zabana, Yamile
Carpio, Daniel
Chaparro, María
Barrio, Jesús
Rivero, Montserrat
López-Sanroman, Antonio
Esteve, María
de Francisco, Ruth
Bastida, Guillermo
García-López, Santiago
Mañosa, Miriam
Martin-Arranz, María Dolores
Pérez-Calle, José Lázaro
Guardiola, Jordi
Muñoz, Fernando
Arranz, Laura
Cabriada, José Luis
García-Sepulcre, Mariana Fe
Navarro, Mercè
Montoro-Huguet, Miguel Ángel
Ricart, Elena
Bermejo, Fernando
Calvet, Xavier
Piqueras, Marta
Garcia-Planella, Esther
Márquez, Lucía
Mínguez, Miguel
Van Domselar, Manuel
Bujanda, Luis
Aldeguer, Xavier
Sicilia, Beatriz
Iglesias, Eva
Alcaín, Guillermo
Pérez-Martínez, Isabel
Rolle, Valeria
Castaño-García, Andrés
P. Gisbert, Javier
Domènech, Eugeni
author_facet Riestra, Sabino
Taxonera, Carlos
Zabana, Yamile
Carpio, Daniel
Chaparro, María
Barrio, Jesús
Rivero, Montserrat
López-Sanroman, Antonio
Esteve, María
de Francisco, Ruth
Bastida, Guillermo
García-López, Santiago
Mañosa, Miriam
Martin-Arranz, María Dolores
Pérez-Calle, José Lázaro
Guardiola, Jordi
Muñoz, Fernando
Arranz, Laura
Cabriada, José Luis
García-Sepulcre, Mariana Fe
Navarro, Mercè
Montoro-Huguet, Miguel Ángel
Ricart, Elena
Bermejo, Fernando
Calvet, Xavier
Piqueras, Marta
Garcia-Planella, Esther
Márquez, Lucía
Mínguez, Miguel
Van Domselar, Manuel
Bujanda, Luis
Aldeguer, Xavier
Sicilia, Beatriz
Iglesias, Eva
Alcaín, Guillermo
Pérez-Martínez, Isabel
Rolle, Valeria
Castaño-García, Andrés
P. Gisbert, Javier
Domènech, Eugeni
author_sort Riestra, Sabino
collection PubMed
description (1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-ץ-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18–20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50–0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66–0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20–22%] vs. 14% [95% CI 13–16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM.
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spelling pubmed-92678532022-07-09 Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU Riestra, Sabino Taxonera, Carlos Zabana, Yamile Carpio, Daniel Chaparro, María Barrio, Jesús Rivero, Montserrat López-Sanroman, Antonio Esteve, María de Francisco, Ruth Bastida, Guillermo García-López, Santiago Mañosa, Miriam Martin-Arranz, María Dolores Pérez-Calle, José Lázaro Guardiola, Jordi Muñoz, Fernando Arranz, Laura Cabriada, José Luis García-Sepulcre, Mariana Fe Navarro, Mercè Montoro-Huguet, Miguel Ángel Ricart, Elena Bermejo, Fernando Calvet, Xavier Piqueras, Marta Garcia-Planella, Esther Márquez, Lucía Mínguez, Miguel Van Domselar, Manuel Bujanda, Luis Aldeguer, Xavier Sicilia, Beatriz Iglesias, Eva Alcaín, Guillermo Pérez-Martínez, Isabel Rolle, Valeria Castaño-García, Andrés P. Gisbert, Javier Domènech, Eugeni J Clin Med Article (1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-ץ-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18–20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50–0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66–0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20–22%] vs. 14% [95% CI 13–16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM. MDPI 2022-07-05 /pmc/articles/PMC9267853/ /pubmed/35807201 http://dx.doi.org/10.3390/jcm11133915 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Riestra, Sabino
Taxonera, Carlos
Zabana, Yamile
Carpio, Daniel
Chaparro, María
Barrio, Jesús
Rivero, Montserrat
López-Sanroman, Antonio
Esteve, María
de Francisco, Ruth
Bastida, Guillermo
García-López, Santiago
Mañosa, Miriam
Martin-Arranz, María Dolores
Pérez-Calle, José Lázaro
Guardiola, Jordi
Muñoz, Fernando
Arranz, Laura
Cabriada, José Luis
García-Sepulcre, Mariana Fe
Navarro, Mercè
Montoro-Huguet, Miguel Ángel
Ricart, Elena
Bermejo, Fernando
Calvet, Xavier
Piqueras, Marta
Garcia-Planella, Esther
Márquez, Lucía
Mínguez, Miguel
Van Domselar, Manuel
Bujanda, Luis
Aldeguer, Xavier
Sicilia, Beatriz
Iglesias, Eva
Alcaín, Guillermo
Pérez-Martínez, Isabel
Rolle, Valeria
Castaño-García, Andrés
P. Gisbert, Javier
Domènech, Eugeni
Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
title Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
title_full Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
title_fullStr Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
title_full_unstemmed Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
title_short Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
title_sort performance of screening strategies for latent tuberculosis infection in patients with inflammatory bowel disease: results from the eneida registry of geteccu
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267853/
https://www.ncbi.nlm.nih.gov/pubmed/35807201
http://dx.doi.org/10.3390/jcm11133915
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