“…21 Although expert comments proposed that after proper LTBI screening, proactive TB therapy has been demonstrated to be effective and well-tolerated to reduce the risk of TB reactivation in RD patients requiring TNFi, 22 there are still case reports of TB reactivation and subsequent poor prognosis in patients with preventive treatment. 23 In addition, as mentioned earlier, LTBI screening before starting biological therapy may not always accurately identify patients at risk of TB reactivation, and the implementation of LTBI screening in RD being widely emphasized, 32% patients received neither TST/IGRA screening nor LTBI treatment before TNFi application. 24 On the other hand, the measurement of pretreatment biomarkers, such as inflammatory cytokine levels, is valuable for prediction of treatment efficacy to TNFi.…”