00e2952aabd20c228892efa06deec4a5 pmc_9267853.pdf d99c974117fdd4fd32108c0bf1927f22d1b5f5f9 pmc_9267853.pdf 6b41d8b7f564db71b89058668fe73699ae0947453a1606c883b1053292505c30 pmc_9267853.pdf Title: Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU Subject: (1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-[scale=1]Definitions/jcm-1765393-i001.pdf-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18–20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50–0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66–0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20–22%] vs. 14% [95% CI 13–16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM. Keywords: inflammatory bowel disease; latent tuberculosis infection; tuberculin skin test; interferon gamma release assays Author: Sabino Riestra, Carlos Taxonera, Yamile Zabana, Daniel Carpio, María Chaparro, Jesús Barrio, Montserrat Rivero, Antonio López-Sanroman, María Esteve, Ruth de Francisco, Guillermo Bastida, Santiago García-López, Miriam Mañosa, María Dolores Martin-Arranz, José Lázaro Pérez-Calle, Jordi Guardiola, Fernando Muñoz, Laura Arranz, José Luis Cabriada, Mariana Fe García-Sepulcre, Mercè Navarro, Miguel Ángel Montoro-Huguet, Elena Ricart, Fernando Bermejo, Xavier Calvet, Marta Piqueras, Esther Garcia-Planella, Lucía Márquez, Miguel Mínguez, Manuel Van Domselar, Luis Bujanda, Xavier Aldeguer, Beatriz Sicilia, Eva Iglesias, Guillermo Alcaín, Isabel Pérez-Martínez, Valeria Rolle, Andrés Castaño-García, Javier P. Gisbert, Eugeni Domènech and on behalf of the ENEIDA registry from GETECCU Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Jul 6 06:11:12 2022 CEST ModDate: Wed Jul 6 06:14:12 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 458273 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WHLIZK+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 IYDCBB+VnURWPalladioL Type 1 Custom yes yes no 15 0 RFBJUO+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 UOLXVJ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 UVNBBN+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 CPLBGF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 76 0 CPLBGH+PalatinoLinotype TrueType WinAnsi yes yes no 79 0 CPLBGJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 82 0 CPLDJN+TimesNewRoman CID TrueType Identity-H yes yes yes 85 0 LDSSDS+EURM10 Type 1 Builtin yes yes no 94 0 TMQSCV+CMSY10 Type 1 Builtin yes yes no 101 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 108 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes no 134 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-15 02:34:01 CEST RepresentationInformation: pmc_9267853.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-09-09 02:19:04 CEST Size: 458273 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 287 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Study Population and Definitions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Performance of Tests and Screening Strategies for Latent Tuberculosis Infection Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Children: Item: Title: Latent Tuberculosis Infection Screening Strategies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: TST/IGRA Dual Screening Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Screening with Two-Step TST (Booster) Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Early Screening Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Interactions between Early Screening and Dual Screening Strategies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Probability of LTBI according to Demographic, IMM Use, and Screening Strategy Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Info: Title: Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU Author: Sabino Riestra, Carlos Taxonera, Yamile Zabana, Daniel Carpio, María Chaparro, Jesús Barrio, Montserrat Rivero, Antonio López-Sanroman, María Esteve, Ruth de Francisco, Guillermo Bastida, Santiago García-López, Miriam Mañosa, María Dolores Martin-Arranz, José Lázaro Pérez-Calle, Jordi Guardiola, Fernando Muñoz, Laura Arranz, José Luis Cabriada, Mariana Fe García-Sepulcre, Mercè Navarro, Miguel Ángel Montoro-Huguet, Elena Ricart, Fernando Bermejo, Xavier Calvet, Marta Piqueras, Esther Garcia-Planella, Lucía Márquez, Miguel Mínguez, Manuel Van Domselar, Luis Bujanda, Xavier Aldeguer, Beatriz Sicilia, Eva Iglesias, Guillermo Alcaín, Isabel Pérez-Martínez, Valeria Rolle, Andrés Castaño-García, Javier P. Gisbert, Eugeni Domènech and on behalf of the ENEIDA registry from GETECCU Subject: (1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-[scale=1]Definitions/jcm-1765393-i001.pdf-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18 20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50 0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66 0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20 22%] vs. 14% [95% CI 13 16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM. 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