Assessing latent tuberculosis infection prior to biologic therapy in psoriasis: a new diagnostic approach with an online interpreter

Zuhal Metin; Kemal Özyurt; Mustafa Atasoy; Efşan Gürbüz Yontar; Ragıp Ertaş; Ozkan Gorgulu

Makale detayları

Assessing latent tuberculosis infection prior to biologic therapy in psoriasis: a new diagnostic approach with an online interpreter

Yazarlar:

Zuhal Metin | Kemal Özyurt | Mustafa Atasoy | Efşan Gürbüz Yontar | Ragıp Ertaş | Ozkan Gorgulu

Yayıncı:

Pamukkale University

Ana Başlıklar:

Bulaşıcı Hastalıklar | Dermatoloji

Dergi:

Pamukkale Tıp Dergisi Vol.17 Issue 1, pp.131-141

Belge Tipi:

Makale

Yayın Tarihi:

1/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001293885

pISSN:

1308-0865

Anahtar kelimeler:

Özet:

 Purpose: The use of biological agents, particularly anti-TNF-alpha treatments, is associated with an elevated risk of tuberculosis TB. Hence, a comprehensive assessment of latent tuberculosis infection LTBI before biologic therapies is imperative. The objective of this study was to evaluate the utility of an online tuberculin skin test TST interferon-γ release assay IGRA interpreter OI-TSTIGRA in assessing the risk of LTBI prior to initiating biological therapies in psoriasis patients. Materials and methods: 116 psoriasis patients who were previously evaluated for TB by a pulmonologist before being treated with a biologic agent were re-evaluated retrospectively with OI-TSTIGRA tstin3d.com. Mean positive predictive value PPV, mean annual risk of development of active tuberculosis ARDATB, and mean cumulative risk of active tuberculosis CRATB values were calculated with OI-TSTIGRA and compared with previous results. Group comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests. Results: The PPV of the LTBI-positive group was significantly higher than the LTBI-negative group. The PPV and ARDATB values of the TST size of 15 mm group were significantly higher than the TST size of 5-9 mm and TST size of 10-15 mm groups. The PPV, ARDATB, and CRATB values of the QuantiFERON-TB Gold Intube test QFT-GIT-positive group were significantly higher than the QFT-GIT-negative group. And the same values of the chest X-ray CXR-positive group were significantly higher than the CXR-negative group. The PPV, ARDATB, and CRATB values were positively correlated with TST, QFT-GIT and CXR results. In addition, the PPV was positively correlated with previous LTBI decisions. Conclusion: OI-TSTIGRA in which many factors are questioned and PPV, ARDATB, and CRATB values are evaluated together, may be a valuable tool for assessing the risk of active TB in psoriasis patients and preventing overdiagnosis and unnecessary prophylaxis.

 Purpose: The use of biological agents, particularly anti-TNF-alpha treatments, is associated with an elevated risk of tuberculosis TB. Hence, a comprehensive assessment of latent tuberculosis infection LTBI before biologic therapies is imperative. The objective of this study was to evaluate the utility of an online tuberculin skin test TST interferon-γ release assay IGRA interpreter OI-TSTIGRA in assessing the risk of LTBI prior to initiating biological therapies in psoriasis patients. Materials and methods: 116 psoriasis patients who were previously evaluated for TB by a pulmonologist before being treated with a biologic agent were re-evaluated retrospectively with OI-TSTIGRA tstin3d.com. Mean positive predictive value PPV, mean annual risk of development of active tuberculosis ARDATB, and mean cumulative risk of active tuberculosis CRATB values were calculated with OI-TSTIGRA and compared with previous results. Group comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests. Results: The PPV of the LTBI-positive group was significantly higher than the LTBI-negative group. The PPV and ARDATB values of the TST size of 15 mm group were significantly higher than the TST size of 5-9 mm and TST size of 10-15 mm groups. The PPV, ARDATB, and CRATB values of the QuantiFERON-TB Gold Intube test QFT-GIT-positive group were significantly higher than the QFT-GIT-negative group. And the same values of the chest X-ray CXR-positive group were significantly higher than the CXR-negative group. The PPV, ARDATB, and CRATB values were positively correlated with TST, QFT-GIT and CXR results. In addition, the PPV was positively correlated with previous LTBI decisions. Conclusion: OI-TSTIGRA in which many factors are questioned and PPV, ARDATB, and CRATB values are evaluated together, may be a valuable tool for assessing the risk of active TB in psoriasis patients and preventing overdiagnosis and unnecessary prophylaxis.

 Purpose: The use of biological agents, particularly anti-TNF-alpha treatments, is associated with an elevated risk of tuberculosis TB. Hence, a comprehensive assessment of latent tuberculosis infection LTBI before biologic therapies is imperative. The objective of this study was to evaluate the utility of an online tuberculin skin test TST interferon-γ release assay IGRA interpreter OI-TSTIGRA in assessing the risk of LTBI prior to initiating biological therapies in psoriasis patients. Materials and methods: 116 psoriasis patients who were previously evaluated for TB by a pulmonologist before being treated with a biologic agent were re-evaluated retrospectively with OI-TSTIGRA tstin3d.com. Mean positive predictive value PPV, mean annual risk of development of active tuberculosis ARDATB, and mean cumulative risk of active tuberculosis CRATB values were calculated with OI-TSTIGRA and compared with previous results. Group comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests. Results: The PPV of the LTBI-positive group was significantly higher than the LTBI-negative group. The PPV and ARDATB values of the TST size of 15 mm group were significantly higher than the TST size of 5-9 mm and TST size of 10-15 mm groups. The PPV, ARDATB, and CRATB values of the QuantiFERON-TB Gold Intube test QFT-GIT-positive group were significantly higher than the QFT-GIT-negative group. And the same values of the chest X-ray CXR-positive group were significantly higher than the CXR-negative group. The PPV, ARDATB, and CRATB values were positively correlated with TST, QFT-GIT and CXR results. In addition, the PPV was positively correlated with previous LTBI decisions. Conclusion: OI-TSTIGRA in which many factors are questioned and PPV, ARDATB, and CRATB values are evaluated together, may be a valuable tool for assessing the risk of active TB in psoriasis patients and preventing overdiagnosis and unnecessary prophylaxis.

 Amaç: Biyolojik ajanların, özellikle de anti-TNF-alfa tedavilerinin kullanımı artmış tüberküloz TB riski ile ilişkilidir. Bu nedenle, biyolojik tedavilerden önce latent tüberküloz enfeksiyonunun LTBI kapsamlı bir şekilde değerlendirilmesi gereklidir. Bu çalışmanın amacı, psöriazis hastalarında biyolojik tedavilere başlamadan önce LTBI riskini değerlendirmek için web tabanlı bir uygulama olan tüberkülin deri testi TST interferon-γ salınım testi IGRA OI-TSTIGRA yorumlayıcısının faydasını değerlendirmektir. Gereç ve yöntem: Biyolojik bir ajanla tedavi edilmeden önce göğüs hastalıkları uzmanı tarafından TB açısından değerlendirilen 116 psoriasis hastası retrospektif olarak OI-TSTIGRA tstin3d.com ile yeniden değerlendirildi. OI-TSTIGRA ile ortalama pozitif prediktif değer PPV, ortalama yıllık aktif tüberküloz gelişme riski ARDATB ve ortalama kümülatif aktif tüberküloz riski CRATB değerleri hesaplandı ve önceki sonuçlarla karşılaştırıldı. Grup karşılaştırmaları Kruskal-Wallis ve Mann- Whitney U testleri kullanılarak yapılmıştır. Bulgular: LTBI-pozitif grubun PPVsi, LTBI-negatif gruptan anlamlı olarak daha yüksekti. TST boyutu 15 mm olan grubun PPV ve ARDATB değerleri, TST boyutu 5-9 mm ve TST boyutu 10-15 mm olan gruplardan anlamlı olarak daha yüksekti. QuantiFERON-TB Gold In-tube test QFT-GIT pozitif grubun PPV, ARDATB ve CRATB değerleri QFT-GIT negatif gruptan anlamlı derecede yüksekti. Akciğer grafisi CXR pozitif grubun aynı değerleri CXR negatif gruptan anlamlı derecede yüksekti. PPV, ARDATB ve CRATB değerleri TST, QFT-GIT ve CXR sonuçları ile pozitif korelasyon göstermiştir. Ayrıca, PPV önceki LTBI kararları ile pozitif korelasyon göstermiştir. Sonuç: Birçok faktörün sorgulandığı ve PPV, ARDATB ve CRATB değerlerinin birlikte değerlendirildiği OI-TST IGRA, psoriasis hastalarında TB riskinin değerlendirilmesinde, yanlış tanı ve gereksiz profilaksinin önlenmesinde değerli bir araç olabilir.

Makale detayları

Assessing latent tuberculosis infection prior to biologic therapy in psoriasis: a new diagnostic approach with an online interpreter

Yazarlar:

Zuhal Metin | Kemal Özyurt | Mustafa Atasoy | Efşan Gürbüz Yontar | Ragıp Ertaş | Ozkan Gorgulu

Yayıncı:

Pamukkale University

Ana Başlıklar:

Bulaşıcı Hastalıklar | Dermatoloji

Dergi:

Pamukkale Tıp Dergisi Vol.17 Issue 1, pp.131-141

Belge Tipi:

Makale

Yayın Tarihi:

1/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001293885

pISSN:

1308-0865

Latent tuberculosis infection

psoriasis

biologic therapyLatent tuberculosis infection

psoriasis

biologic therapy

Sayı

Makale detayları

Assessing latent tuberculosis infection prior to biologic therapy in psoriasis: a new diagnostic approach with an online interpreter

Yazarlar: Zuhal Metin | Kemal Özyurt | Mustafa Atasoy | Efşan Gürbüz Yontar | Ragıp Ertaş | Ozkan Gorgulu

Yayıncı: Pamukkale University

Ana Başlıklar: Bulaşıcı Hastalıklar | Dermatoloji

Dergi: Pamukkale Tıp Dergisi Vol.17 Issue 1, pp.131-141

Belge Tipi: Makale

Yayın Tarihi: 1/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001293885

pISSN: 1308-0865

Latent tuberculosis infection

psoriasis

biologic therapyLatent tuberculosis infection

psoriasis

biologic therapy

Sayı

Yazarlar:

Zuhal Metin | Kemal Özyurt | Mustafa Atasoy | Efşan Gürbüz Yontar | Ragıp Ertaş | Ozkan Gorgulu

Yayıncı:

Pamukkale University

Ana Başlıklar:

Bulaşıcı Hastalıklar | Dermatoloji

Dergi:

Pamukkale Tıp Dergisi Vol.17 Issue 1, pp.131-141

Belge Tipi:

Makale

Yayın Tarihi:

1/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001293885

pISSN:

1308-0865