Tuberculosis Infection Versus Anti-tumor Necrosis Factor Therapy: Screening Challenges in Psoriatic Patients

Overview

Journal J Drug Assess

Date 2016 Aug 19

PMID 27536430

Citations 1

Authors

Caius Solovan

Elena Chiticariu

Adelina Timofte

Irina Stoia-Djeska

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of this study was to analyze the performance of the tuberculin skin test (TST) for screening and monitoring patients treated with anti-tumor necrosis factor agents, in a high-incidence area.

Methods: A 3-year retrospective study was carried out on 268 subjects. The study included 68 patients with moderate-to-severe psoriasis, screened for latent tuberculosis infection (LTBI) and subjects without psoriasis (100 adults and 100 children) with close contact with infected individuals.

Results: Positive tuberculin skin test (TST) results (induration >5 mm) were observed in 70.5% (48/68) of patients with psoriasis, higher than those observed in subjects with suspicion of tuberculosis or with close contact with infected individuals: 51% (51/100) in the adult group and 30% (30/100) in the children group.

Conclusions: These results show that the prevalence of LTBI evaluated with the TST in the psoriatic group is higher than in subjects without psoriasis.

Limitation: The positive reactions were not confirmed by other verification methods.

Citing Articles

Psoriasis, anti-tumor necrosis factor therapy, and tuberculosis: report of three challenging cases and literature review.

Solovan C, Chiticariu E Infect Dis Ther. 2014; 2(1):59-73.

PMID: 25135824 PMC: 4108098. DOI: 10.1007/s40121-013-0003-9.

References

Miller R . The Koebner phenomenon. Int J Dermatol. 1982; 21(4):192-7. DOI: 10.1111/j.1365-4362.1982.tb02070.x. View

Santin Cerezales M, Dominguez Benitez J . Diagnosis of tuberculosis infection using interferon-γ-based assays. Enferm Infecc Microbiol Clin. 2011; 29 Suppl 1:26-33. DOI: 10.1016/S0213-005X(11)70015-5. View

Ponce de Leon D, Acevedo-Vasquez E, Sanchez-Torres A, Cucho M, Alfaro J, Perich R . Attenuated response to purified protein derivative in patients with rheumatoid arthritis: study in a population with a high prevalence of tuberculosis. Ann Rheum Dis. 2005; 64(9):1360-1. PMC: 1755642. DOI: 10.1136/ard.2004.029041. View

Dogan B, Harmanyeri Y . Intradermal antigen tests and the Koebner phenomenon in psoriasis. Int J Dermatol. 1997; 36(4):263-5. DOI: 10.1046/j.1365-4362.1997.00164.x. View

Koga T, Duan H, Urabe K, Furue M . In situ localization of IFN-gamma-positive cells in psoriatic lesional epidermis. Eur J Dermatol. 2002; 12(1):20-3. View

Katsenos S, Nikolopoulou M, Tsiouri G, Bassukas I, Constantopoulos S . The Challenging Evaluation of Patients with Severe Psoriasis for Latent Tuberculosis: An Important Indication for IGRA. Open Respir Med J. 2011; 5:59-60. PMC: 3132865. DOI: 10.2174/1874306401105010059. View

Szegedi A, Aleksza M, Gonda A, Irinyi B, Sipka S, Hunyadi J . Elevated rate of Thelper1 (T(H)1) lymphocytes and serum IFN-gamma levels in psoriatic patients. Immunol Lett. 2003; 86(3):277-80. DOI: 10.1016/s0165-2478(03)00025-7. View

Zabana Y, Domenech E, Lopez San Roman A, Beltran B, Cabriada J, Saro C . Tuberculous chemoprophylaxis requirements and safety in inflammatory bowel disease patients prior to anti-TNF therapy. Inflamm Bowel Dis. 2008; 14(10):1387-91. DOI: 10.1002/ibd.20496. View

Narayanan P . Influence of sex, age & nontuberculous infection at intake on the efficacy of BCG: re-analysis of 15-year data from a double-blind randomized control trial in South India. Indian J Med Res. 2006; 123(2):119-24. View

10.

Tubach F, Salmon D, Ravaud P, Allanore Y, Goupille P, Breban M . Risk of tuberculosis is higher with anti-tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three-year prospective French Research Axed on Tolerance of Biotherapies registry. Arthritis Rheum. 2009; 60(7):1884-94. PMC: 2921546. DOI: 10.1002/art.24632. View

11.

Lalvani A, Millington K . Screening for tuberculosis infection prior to initiation of anti-TNF therapy. Autoimmun Rev. 2008; 8(2):147-52. PMC: 2593775. DOI: 10.1016/j.autrev.2008.07.011. View

12.

Tsiouri G, Gaitanis G, Kiorpelidou D, Dionysiou A, Efthymiou A, Daskalopoulos G . Tuberculin skin test overestimates tuberculosis hypersensitivity in adult patients with psoriasis. Dermatology. 2009; 219(2):119-25. DOI: 10.1159/000222431. View