Comparison of interferon {gamma} release assays and conventional screening tests before tumour necrosis factor {alpha} blockade in patients with inflammatory arthritis.

Hdl Handle:
http://hdl.handle.net/10147/207022
Title:
Comparison of interferon {gamma} release assays and conventional screening tests before tumour necrosis factor {alpha} blockade in patients with inflammatory arthritis.
Authors:
Martin, J; Walsh, C; Gibbs, A; McDonnell, T; Fearon, U; Keane, J; Codd, M B; Dodd, J; Veale, D; Fitzgerald, O; Bresnihan, B
Affiliation:
Departments of Rheumatology, Respiratory Medicine and Radiology, St Vincent's, University Hospital, Dublin 4, Ireland.
Citation:
Ann Rheum Dis. 2010 Jan;69(1):181-5. Epub .
Journal:
Annals of the rheumatic diseases
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207022
DOI:
10.1136/ard.2008.101857
PubMed ID:
19176545
Abstract:
OBJECTIVE: To compare the performance of two interferon gamma release assays (IGRAs) and conventional screening tests in patients with inflammatory arthritis undergoing screening for latent tuberculosis infection (LTBI) before treatment with anti-tumour necrosis factor alpha (anti-TNFalpha) compounds. METHODS: Successive patients were subjected to conventional LTBI screening, including a tuberculin skin test (TST). The T-SPOT.TB test was performed on all patients and the QuantiFERON-TB Gold test was performed on a large subset. The results of the IGRAs were compared with the results of conventional screening tests. RESULTS: A total 150 patients were evaluated. The majority (57.9%) had rheumatoid arthritis. Previous vaccination with Bacille Calmette-Guerin was confirmed in 82% of patients. No patient had received prior anti-TB treatment. A total of 57 patients (38.0%) had at least one positive conventional risk factor. In contrast, an unequivocally positive T-SPOT.TB test was seen in only 14/143 (9.8%). There was 98.2% agreement between the two IGRAs. Statistically significant associations were found between each of the IGRAs and both TST and risk history, but not chest x-ray (CXR). A positive IGRA result was significantly associated with increased age. TB was not reactivated in any patient during the follow-up period. Interpretation: This study suggests that IGRAs may be useful when screening for LTBI before anti-TNFalpha therapy in patients with immune-mediated inflammatory diseases. The observations reported here also highlight the inadequate performance of CXR as a marker of LTBI.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Antirheumatic Agents/*therapeutic use; Arthritis/complications/drug therapy/*immunology; Arthritis, Rheumatoid/complications/drug therapy/immunology; Humans; Interferon-gamma/*biosynthesis; Latent Tuberculosis/complications/*diagnosis/immunology; Mass Screening/methods; Middle Aged; Tuberculin Test; Tumor Necrosis Factor-alpha/*antagonists & inhibitors; Young Adult
ISSN:
1468-2060 (Electronic); 0003-4967 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMartin, Jen_GB
dc.contributor.authorWalsh, Cen_GB
dc.contributor.authorGibbs, Aen_GB
dc.contributor.authorMcDonnell, Ten_GB
dc.contributor.authorFearon, Uen_GB
dc.contributor.authorKeane, Jen_GB
dc.contributor.authorCodd, M Ben_GB
dc.contributor.authorDodd, Jen_GB
dc.contributor.authorVeale, Den_GB
dc.contributor.authorFitzgerald, Oen_GB
dc.contributor.authorBresnihan, Ben_GB
dc.date.accessioned2012-02-01T10:28:28Z-
dc.date.available2012-02-01T10:28:28Z-
dc.date.issued2012-02-01T10:28:28Z-
dc.identifier.citationAnn Rheum Dis. 2010 Jan;69(1):181-5. Epub .en_GB
dc.identifier.issn1468-2060 (Electronic)en_GB
dc.identifier.issn0003-4967 (Linking)en_GB
dc.identifier.pmid19176545en_GB
dc.identifier.doi10.1136/ard.2008.101857en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207022-
dc.description.abstractOBJECTIVE: To compare the performance of two interferon gamma release assays (IGRAs) and conventional screening tests in patients with inflammatory arthritis undergoing screening for latent tuberculosis infection (LTBI) before treatment with anti-tumour necrosis factor alpha (anti-TNFalpha) compounds. METHODS: Successive patients were subjected to conventional LTBI screening, including a tuberculin skin test (TST). The T-SPOT.TB test was performed on all patients and the QuantiFERON-TB Gold test was performed on a large subset. The results of the IGRAs were compared with the results of conventional screening tests. RESULTS: A total 150 patients were evaluated. The majority (57.9%) had rheumatoid arthritis. Previous vaccination with Bacille Calmette-Guerin was confirmed in 82% of patients. No patient had received prior anti-TB treatment. A total of 57 patients (38.0%) had at least one positive conventional risk factor. In contrast, an unequivocally positive T-SPOT.TB test was seen in only 14/143 (9.8%). There was 98.2% agreement between the two IGRAs. Statistically significant associations were found between each of the IGRAs and both TST and risk history, but not chest x-ray (CXR). A positive IGRA result was significantly associated with increased age. TB was not reactivated in any patient during the follow-up period. Interpretation: This study suggests that IGRAs may be useful when screening for LTBI before anti-TNFalpha therapy in patients with immune-mediated inflammatory diseases. The observations reported here also highlight the inadequate performance of CXR as a marker of LTBI.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAntirheumatic Agents/*therapeutic useen_GB
dc.subject.meshArthritis/complications/drug therapy/*immunologyen_GB
dc.subject.meshArthritis, Rheumatoid/complications/drug therapy/immunologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInterferon-gamma/*biosynthesisen_GB
dc.subject.meshLatent Tuberculosis/complications/*diagnosis/immunologyen_GB
dc.subject.meshMass Screening/methodsen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshTuberculin Testen_GB
dc.subject.meshTumor Necrosis Factor-alpha/*antagonists & inhibitorsen_GB
dc.subject.meshYoung Adulten_GB
dc.titleComparison of interferon {gamma} release assays and conventional screening tests before tumour necrosis factor {alpha} blockade in patients with inflammatory arthritis.en_GB
dc.contributor.departmentDepartments of Rheumatology, Respiratory Medicine and Radiology, St Vincent's, University Hospital, Dublin 4, Ireland.en_GB
dc.identifier.journalAnnals of the rheumatic diseasesen_GB
dc.description.provinceLeinster-

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