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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Authors: Riestra, S, Taxonera, C, Zabana, Y, Carpio, D, Chaparro, M, Barrio, J, Rivero, M, Lopez-Sanroman, A, Esteve, M, de Francisco, R, Bastida, G, Garcia-Lopez, S, Manosa, M, Martin-Arranz, MD, Perez-Calle, JL, Guardiola, J, Munoz, F, Arranz, L, Cabriada, JL, Garcia-Sepulcre, MF, Navarro, M, Montoro-Huguet, MA, Ricart, E, Bermejo, F, Calvet, X, Piqueras, M, Garcia-Planella, E, Marquez, L, Minguez, M, Van Domselar, M, Bujanda, L, Aldeguer, X, Sicilia, B, Iglesias, E, Alcain, G, Perez-Martinez, I, Rolle, V, Castano-Garcia, A, Gisbert, JP, Domenech, E
Format: article
Status:Published version
Publication Date:2022
Country:España
Institution:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repository:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p12018
Online Access:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12018
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137377290&doi=10.3390%2fjcm11133915&partnerID=40&md5=12d7caba530e15adc4d684910ca33a56
Access Level:Open access
Keyword:inflammatory bowel disease
latent tuberculosis infection
tuberculin skin test
interferon gamma release assays
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spelling Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCURiestra, STaxonera, CZabana, YCarpio, DChaparro, MBarrio, JRivero, MLopez-Sanroman, AEsteve, Mde Francisco, RBastida, GGarcia-Lopez, SManosa, MMartin-Arranz, MDPerez-Calle, JLGuardiola, JMunoz, FArranz, LCabriada, JLGarcia-Sepulcre, MFNavarro, MMontoro-Huguet, MARicart, EBermejo, FCalvet, XPiqueras, MGarcia-Planella, EMarquez, LMinguez, MVan Domselar, MBujanda, LAldeguer, XSicilia, BIglesias, EAlcain, GPerez-Martinez, IRolle, VCastano-Garcia, AGisbert, JPDomenech, Einflammatory bowel diseaselatent tuberculosis infectiontuberculin skin testinterferon gamma release assays(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-gamma-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.MDPI2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12018https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137377290&doi=10.3390%2fjcm11133915&partnerID=40&md5=12d7caba530e15adc4d684910ca33a56Journal of Clinical MedicineISSN: 20770383reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p120182026-06-14T12:41:47Z
dc.title.none.fl_str_mv 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
spellingShingle Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
Riestra, S
inflammatory bowel disease
latent tuberculosis infection
tuberculin skin test
interferon gamma release assays
title_short 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_sort Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU
dc.creator.none.fl_str_mv Riestra, S
Taxonera, C
Zabana, Y
Carpio, D
Chaparro, M
Barrio, J
Rivero, M
Lopez-Sanroman, A
Esteve, M
de Francisco, R
Bastida, G
Garcia-Lopez, S
Manosa, M
Martin-Arranz, MD
Perez-Calle, JL
Guardiola, J
Munoz, F
Arranz, L
Cabriada, JL
Garcia-Sepulcre, MF
Navarro, M
Montoro-Huguet, MA
Ricart, E
Bermejo, F
Calvet, X
Piqueras, M
Garcia-Planella, E
Marquez, L
Minguez, M
Van Domselar, M
Bujanda, L
Aldeguer, X
Sicilia, B
Iglesias, E
Alcain, G
Perez-Martinez, I
Rolle, V
Castano-Garcia, A
Gisbert, JP
Domenech, E
author Riestra, S
author_facet Riestra, S
Taxonera, C
Zabana, Y
Carpio, D
Chaparro, M
Barrio, J
Rivero, M
Lopez-Sanroman, A
Esteve, M
de Francisco, R
Bastida, G
Garcia-Lopez, S
Manosa, M
Martin-Arranz, MD
Perez-Calle, JL
Guardiola, J
Munoz, F
Arranz, L
Cabriada, JL
Garcia-Sepulcre, MF
Navarro, M
Montoro-Huguet, MA
Ricart, E
Bermejo, F
Calvet, X
Piqueras, M
Garcia-Planella, E
Marquez, L
Minguez, M
Van Domselar, M
Bujanda, L
Aldeguer, X
Sicilia, B
Iglesias, E
Alcain, G
Perez-Martinez, I
Rolle, V
Castano-Garcia, A
Gisbert, JP
Domenech, E
author_role author
author2 Taxonera, C
Zabana, Y
Carpio, D
Chaparro, M
Barrio, J
Rivero, M
Lopez-Sanroman, A
Esteve, M
de Francisco, R
Bastida, G
Garcia-Lopez, S
Manosa, M
Martin-Arranz, MD
Perez-Calle, JL
Guardiola, J
Munoz, F
Arranz, L
Cabriada, JL
Garcia-Sepulcre, MF
Navarro, M
Montoro-Huguet, MA
Ricart, E
Bermejo, F
Calvet, X
Piqueras, M
Garcia-Planella, E
Marquez, L
Minguez, M
Van Domselar, M
Bujanda, L
Aldeguer, X
Sicilia, B
Iglesias, E
Alcain, G
Perez-Martinez, I
Rolle, V
Castano-Garcia, A
Gisbert, JP
Domenech, E
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv inflammatory bowel disease
latent tuberculosis infection
tuberculin skin test
interferon gamma release assays
topic inflammatory bowel disease
latent tuberculosis infection
tuberculin skin test
interferon gamma release assays
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-gamma-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.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12018
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137377290&doi=10.3390%2fjcm11133915&partnerID=40&md5=12d7caba530e15adc4d684910ca33a56
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12018
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137377290&doi=10.3390%2fjcm11133915&partnerID=40&md5=12d7caba530e15adc4d684910ca33a56
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Journal of Clinical Medicine
ISSN: 20770383
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869418942300160000
score 15,811543

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