Comparison of two interferon-  release assays and tuberculin skin test for detecting latent tuberculosis in patients with immune-mediated inflammatory diseases

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

“…These findings, which are in accordance with recent studies (2,21,23,24,31), establish the value of IGRAs for LTBI screening in rheumatic patients receiving anti-TNF agents.…”

“…In contrast to two previous studies (21,23) in which small numbers of patients with positive IGRAs were included (8 to 10%), a relatively large number of patients with positive IGRA results was found in our study population (21 to 25%). A moderate rate of agreement (81% agreement rate; ϭ 0.47) was observed between the two IGRAs, which is close to what has been reported in the literature for rheumatic populations (0.48 to 0.67) (5,21). In contrast to a recent study by Kleinert et al (21), who utilized the QFT-G assay and found a high rate of indeterminate results (18%), the rate of indeterminate results in our study was only 1.3%.…”

“…In contrast to a recent study by Kleinert et al (21), who utilized the QFT-G assay and found a high rate of indeterminate results (18%), the rate of indeterminate results in our study was only 1.3%. Discordant results between IGRAs were observed in approximately 20% of the cases, compared to discordance rates of 10 to 15% in previous studies (5,21). Among our patients, more had positive T-SPOT.TB and negative QFT-GIT results, and this group more frequently had a positive TST.…”

“…Although there have been a number of studies evaluating the performance of IGRAs in comparison to TST in rheumatic patients (2,4,10,23,24,29,31,32), head-to-head studies with an adequate number of patients to compare all three assays are limited (5,21). Furthermore, combined approaches for LTBI diagnosis incorporating the results of the individual IGRAs and TST have not been explored adequately so far.…”

Prednisolone treatment affects the performance of the QuantiFERON gold in-tube test and the tuberculin skin test in patients with autoimmune disorders screened for latent tuberculosis infection

“…Interestingly, this effect was alone mediated by prednisolone and not by long-acting injectable corticosteroid or any of the disease-modifying antirheumatic drugs (DMARDs). Previous studies assessing the effect of immunosuppressive therapy on IGRA performance have been contradictory, reporting either that DMARDs did 23,28,[30][31][32] or did not 25,33,34 affect the performance of IGRA. These contradictory findings are probably due to differences in study population, low sample size, variable drug regimens, different doses, or different combination of medication or because the both fast-and long-acting corticosteroids and other DMARDs were pooled in the analysis.…”