scholarly journals Steroids Decrease Prevalence of Positive Tuberculin Skin Test in Rheumatoid Arthritis: Implications on Anti-TNF Therapies

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shweta Agarwal ◽  
Siddharth Kumar Das ◽  
Girdhar G. Agarwal ◽  
Ragini Srivastava
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Standard Treatment ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Positive Tuberculin Skin Test ◽  
Test Results ◽  
Disease Modifying Antirheumatic Drugs ◽  
Cross Sectional

Tuberculin skin test has been used as an indicator of latent tuberculosis in patients with Rheumatoid Arthritis (RA) before administration of biologicals. Effect of Disease modifying antirheumatic drugs (DMARDs) and steroids on the result of tuberculin skin test (TST) may have important implications in interpretation of results of this test.Objectives. To find the prevalence of positive TST in rheumatoid patients and the effect of standard treatment on the results of TST.Method. In this cross-sectional study two hundred and fifty patients of RA above 18 years of age, classified using 1987 ACR criteria for RA, were enrolled from rheumatology outdoor. Demographics, disease activity, disease duration, and therapy were recorded. All patients underwent TST.Results. Fifty-one (20.4%) patients were found to be tuberculin positive. Tuberculin positivity was not affected by MTX intake but it was significantly low in patients with recent steroid intake as compared to patients who had not taken steroids in last 3 months (3% versus 25%,P= 0.002).Conclusion. Prevalence of tuberculin positivity in patients with RA was found to be low. Results were not affected by methotrexate; however tuberculin skin test results in patients with recent use of steroids are likely to be negative.

scholarly journals Comparison of the QuantiFERON-TB and tuberculin skin test for detection of latent tuberculosis infection in cancer patients in a developing country

2019 ◽  
Vol 5 (4) ◽  
pp. 00258-2018
Author(s):  
Javier Leonardo Galindo ◽  
Adriana Catalina Galeano ◽  
David Alfonso Suarez-Zamora ◽  
Ana Milena Callejas ◽  
Mónica Patricia Caicedo-Verástegui ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Cancer Patients ◽  
Skin Test ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Tuberculosis Infection ◽  
Test Results ◽  
Cross Sectional ◽  
Increased Risk

Cancer patients have an increased risk of reactivation of latent tuberculosis infection. It is unknown which strategy on screening should be used in this population in developing countries. We aimed to determine the concordance between the tuberculin skin test (TST) and QuantiFERON®-TB (QFT) assay in order to diagnose latent tuberculosis infection in cancer patients.We conducted a cross-sectional study of the agreement of diagnostic tests. Prevalence and agreement between tests were calculated. A logistic regression to assess predictors of discordance was performed. The accuracy of the TST to predict QFT results by a receiver operating characteristic (ROC) curve was evaluated.We included 149 adults with cancer without active tuberculosis. Prevalence of latent tuberculosis infection was 21.5% (n=32), defined as positive results on either test. Test agreement was moderate for the diagnosis of latent tuberculosis infection (κ=0.43, 90% CI 0.26–0.6). No predictor was associated with the chance of discordant results. Agreement improved slightly using a cut-off point ≥8 mm (κ=0.5, 90% CI 0.35–0.66).In a moderate-incidence setting, a moderate agreement was found between tests in cancer patients. Modification of the cut-off points of test results achieved marginally better agreement between the TST and QFT.

scholarly journals Investigating the safety and compliance of using csDMARDs in rheumatoid arthritis treatment through face-to-face interviews: a cross-sectional study in China

2020 ◽  
Author(s):  
Jiaying Sun ◽  
Siming Dai ◽  
Ling Zhang ◽  
Yajing Feng ◽  
Xin Yu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Standard Treatment ◽  
Cross Sectional Study ◽  
Chinese Patients ◽  
Disease Modifying Antirheumatic Drugs ◽  
Cross Sectional ◽  
Face To Face ◽  
Class A ◽  
Key Points ◽  
Tier 3

Abstract Rheumatoid arthritis (RA) significantly impacts the health of Chinese patients. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are used as the standard treatment for patients with RA. However, Chinese patients with RA have reported poor compliance with csDMARDs. This study aims to better understand the safety and compliance of using csDMARDs in RA treatment. Face-to-face interviews were conducted by questionnaires on safety and compliance of csDMARDs in 400 patients with RA and 100 rheumatologists from 13 cities in China. Rheumatologists were from Tier 3 Class A hospitals with independent rheumatology departments, who admitted more than 30 patients with RA per week. All patients were diagnosed for > 3 months before the survey and had been treated with csDMARDs for > 3 months. The incidence of adverse events (AEs) that attributed to csDMARDs estimated by rheumatologists was lower than that reported by patients for all four prescribed csDMARDs. Also, types of common AEs in rheumatologist’s perception differed from those in the patient’s report. Only 86% (116/135) of patients claimed they notified their rheumatologist about AEs, and 40.8% (150/368) of patients did not strictly adhere to their prescribed treatment. Reasons why patients were not compliant with their treatment, other than AEs, included symptoms being less severe, travel, and busy working life/business trips. This study revealed gaps in perceptions of csDMARDs-related AEs and medication adherence between rheumatologists and patients. These findings suggested adequate doctor-patient communications, and considerations of multiple real-world situations may improve adherence in the treatment of RA patients. Key Points• This study identified gaps in rheumatologists’ perception of the prevalence and type of AEs experienced by their patients, which could potentially help them improve their patients’ compliance with treatment.

Screening for Tuberculosis Infection in Spanish Healthcare Workers Comparison of the QuantiFERON-TB Gold In-Tube Test with the Tuberculin Skin Test

2009 ◽  
Vol 30 (9) ◽  
pp. 876-883 ◽  
Author(s):  
Eva Elisa Àlvarez-León ◽  
Elizabeth Espinosa-Vega ◽  
Évora Santana-Rodríguez ◽  
Jesús M. Molina-Cabrillana ◽  
Jose Luis Pérez-Arellano ◽  
...  
Keyword(s):  
Positive Result ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Healthcare Workers ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Negative Results

Objective.The risk of latent tuberculosis (LTBI) in healthcare workers (HCWs) is high. Until recently, the tuberculin skin test (TST) was the only diagnostic test available for Mycobacterium tuberculosis infection. A new enzyme-linked immunosorbent assay test, the QuantiFERON-TB Gold (QFT-G) test, was recommended by the US Centers for Disease Control and Prevention as an alternative test for the diagnosis of LTBI in HCWs. The purpose of our study was to compare the TST and the QFT-G test in Spanish HCWs in order to improve procedures for the detection of LTBI.Methods.A cross-sectional study with blinded comparison of TST and QFT-G test results was carried out among 134 HCWs at an 800-bed Spanish university hospital. The level of interferon-7 production stimulated by the QFT-G test was measured. A concentration of at least 0.35 IU/mL was considered a positive result. An induration of at least 5 mm in non-BCG-vaccinated or at least 15 mm in BCG-vaccinated HCWs for the TST was considered positive.Results.Of the 134 HCWs included (mean age, 33.4 years; 101 [75.4%] women; 47 [35.1%] BCG vaccinated), the LTBI prevalence diagnosed with any test was 11.2% (95% confidence interval, 6.6%-18.1%), with the TST was 8.96%, and with the QFT-G test was 5.97% (nonsignificant differences). The QFT-G test value was higher in subjects with TST induration of at least 15 mm than in subjects with TST induration of less than 15 mm (P < .001). Overall agreement between the results of the two tests was found in 94% of HCWs (K = 0.56), but agreement was only 59% in HCWs who had a positive result for both tests. Disagreement was present in the results found for 5% of HCWs.Conclusions.Few studies have compared both tests in populations with high M. tuberculosis exposure but low BCG vaccination prevalence. Agreement between both tests is high, especially among negative Results. Studies are needed to clarify the reasons for disagreement and to establish the best TST and QFT-G test cutoff point.

scholarly journals Prevalence and predictors of positive tuberculin skin test results in a research laboratory

2008 ◽  
Vol 41 (4) ◽  
pp. 416-418 ◽  
Author(s):  
Florian H. Pilsczek ◽  
Stefan H.E. Kaufmann
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Research Laboratory ◽  
Latent Tuberculosis ◽  
Positive Tuberculin Skin Test ◽  
Active Tuberculosis ◽  
Test Results ◽  
Place Of Birth ◽  
High Prevalence ◽  
History Of

Latent tuberculosis was studied in a research laboratory. A prevalence of positive tuberculin skin test results (> 15mm) of 20% was found and the main predictors were place of birth in a foreign country with high prevalence of tuberculosis and a history of contact with patients with untreated active tuberculosis.

Active Tuberculosis in a Healthcare Worker: Are You Ready?

2009 ◽  
Vol 30 (1) ◽  
pp. 80-82 ◽  
Author(s):  
Thomas G. Fraser ◽  
Joan Kowalczyk ◽  
Steven Schmitt ◽  
Jill Bernstein ◽  
Paul Terpeluk ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Healthcare Worker ◽  
Skin Test ◽  
Latent Tuberculosis ◽  
Control Program ◽  
Positive Tuberculin Skin Test ◽  
Active Tuberculosis ◽  
Test Results ◽  
Potential Benefits ◽  
Skin Test Result

We describe a healthcare worker with a previously positive tuberculin skin test result who developed active tuberculosis. An investigation revealed 280 potential contacts, 3 of whom had positive tuberculin skin test results. Our experience demonstrates the potential benefits of therapy for latent tuberculosis infection as a component of a tuberculosis-control program.

Increased detection of latent tuberculosis by tuberculin skin test and booster phenomenon in early rheumatoid arthritis patients

2015 ◽  
Vol 35 (9) ◽  
pp. 1555-1559 ◽  
Author(s):  
L. Pérez-Barbosa ◽  
J. A. Esquivel-Valerio ◽  
A. C. Arana-Guajardo ◽  
D. Vega-Morales ◽  
J. Riega-Torres ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Early Rheumatoid Arthritis ◽  
Latent Tuberculosis

Adherence of rheumatoid arthritis patients to biologic disease-modifying antirheumatic drugs: a cross-sectional study

2017 ◽  
Vol 37 (10) ◽  
pp. 1709-1718 ◽  
Author(s):  
Natalia Mena-Vazquez ◽  
Sara Manrique-Arija ◽  
Lucía Yunquera-Romero ◽  
Inmaculada Ureña-Garnica ◽  
Marta Rojas-Gimenez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Disease Modifying
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