Screening for latent tuberculosis before starting TNF-alpha inhibitors in a population with high BCG vaccination rates

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dc.authoridBorekci, Sermin/0000-0002-0089-1312en_US
dc.authoridHamuryudan, Vedat/0000-0001-6625-1652en_US
dc.authoridMelikoğlu, Meltem Alkan/0000-0001-7519-9470en_US
dc.authoridHatemi, Ali Ibrahim/0000-0002-8385-9253en_US
dc.authoridesatoğlu, sinem nihal/0000-0001-5414-7305en_US
dc.authoridHacıoğlu, Aysa/0000-0002-6197-5659en_US
dc.authoridSeyahi, Emire/0000-0003-4965-2918en_US
dc.contributor.authorHacıoğlu, Aysa
dc.contributor.authorBorekci, Sermin
dc.contributor.authorMelikoğlu, Melike
dc.contributor.authorÖzguler, Yeşim
dc.contributor.authorEsatoğlu, Sinem Nihal
dc.contributor.authorUgurlu, Serdal
dc.contributor.authorSeyahi, Emire
dc.date.accessioned2024-07-12T21:37:27Z
dc.date.available2024-07-12T21:37:27Z
dc.date.issued2022en_US
dc.department[Belirlenecek]en_US
dc.description.abstractIt is assumed that in candidates for TNF-alpha inhibitor (TNFi) treatment, tuberculin skin test (TST) may be unreliable, since BCG vaccination causes false positive and drugs cause false negative results, favoring the use of Quantiferon or T-spot assays. However, these tests may not be readily available in all parts of the world. We aimed to determine the reliability of TST with respect to BCG vaccination and drugs in candidates for TNFi treatment, and how isoniazid is tolerated, assuming that the use of TST would result in increased isoniazid use. We included 1031 adult patients who were prescribed a TNFi for the first time. We analysed the association of BCG and drugs with TST and Quantiferon results, the determinants of a positive TST, and evaluated the tolerability of isoniazid. BCG vaccination and male sex were associated with positive TST (OR 3.56, 95% CI 1.98-6.41 and OR 2.54, 95% CI 1.75-3.68, respectively), while prednisolone and azathioprine were associated with negative TST (OR 0.63, 95% CI 0.43-0.91 and OR 0.40, 95% CI 0.11-0.76). Isoniazid was prescribed to 684 (66.3%) patients and had to be discontinued in 12.2% of these before 9 months, most commonly due to hepatotoxicity (44%). One patient developed tuberculosis despite isoniazid use. BCG vaccination may be associated with false positive TST, despite a long time since vaccination in candidates for TNFi treatment. Prednisolone and azathioprine use were associated with negative TST. Despite the high frequency of isoniazid use associated with using TST instead of QTF, isoniazid was generally well tolerated.en_US
dc.identifier.doi10.1007/s00296-021-04926-z
dc.identifier.endpage1451en_US
dc.identifier.issn0172-8172
dc.identifier.issn1437-160X
dc.identifier.issue8en_US
dc.identifier.pmid34228162en_US
dc.identifier.scopus2-s2.0-85109313444en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage1443en_US
dc.identifier.urihttps://doi.org/10.1007/s00296-021-04926-z
dc.identifier.urihttps://hdl.handle.net/20.500.12415/6775
dc.identifier.volume42en_US
dc.identifier.wosWOS:000670143900001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringer Heidelbergen_US
dc.relation.ispartofRheumatology Internationalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKY04117
dc.subjectBcg Vaccineen_US
dc.subjectIsoniaziden_US
dc.subjectTuberculin Testen_US
dc.subjectTuberculosisen_US
dc.subjectTumor Necrosis Factor-Alphaen_US
dc.titleScreening for latent tuberculosis before starting TNF-alpha inhibitors in a population with high BCG vaccination ratesen_US
dc.typeArticle
dspace.entity.typePublication

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