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Should all patients undergoing treatment with biologic agents be screened annually for latent tuberculosis infection with an interferon gamma release assay?

Publication ,  Journal Article
Johnson, MG; Bialas, RW; Hall, RP; Stout, JE
Published in: J Dermatolog Treat
August 2016

Systemic biologic therapy has become commonplace for the treatment of a variety of inflammatory dermatologic conditions, particularly psoriasis. Screening for latent tuberculosis infection (LTBI) is recommended prior to initiation of systemic biologic agents, and an interferon gamma release assays (IGRA) is often used as the screening modality. Annual screening for LTBI is also recommended for patients while on systemic biologic therapy, but the literature does not clearly support how often screening should be performed. In addition, serial testing with IGRAs, particularly among low-risk populations without any new tuberculosis (TB) exposures, has proven to be unreliable with frequent reversions and conversions. We propose that in low-incidence TB regions, repeat LTBI screening should only be considered for patients on systemic biologic therapy if any new TB exposures occurred since initial LTBI screening was performed prior to starting biologic therapy. This strategy aims to reduce false-positive LTBI testing that can expose patients to hazardous antibiotics and result in the unnecessary interruption of systemic biologic therapy.

Duke Scholars

Published In

J Dermatolog Treat

DOI

EISSN

1471-1753

Publication Date

August 2016

Volume

27

Issue

4

Start / End Page

378 / 380

Location

England

Related Subject Headings

  • Psoriasis
  • Mass Screening
  • Male
  • Latent Tuberculosis
  • Interferon-gamma Release Tests
  • Incidence
  • Humans
  • Dermatology & Venereal Diseases
  • Biological Factors
  • Aged, 80 and over
 

Citation

APA
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ICMJE
MLA
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Johnson, M. G., Bialas, R. W., Hall, R. P., & Stout, J. E. (2016). Should all patients undergoing treatment with biologic agents be screened annually for latent tuberculosis infection with an interferon gamma release assay? J Dermatolog Treat, 27(4), 378–380. https://doi.org/10.3109/09546634.2015.1115815
Johnson, M. G., R. W. Bialas, R. P. Hall, and J. E. Stout. “Should all patients undergoing treatment with biologic agents be screened annually for latent tuberculosis infection with an interferon gamma release assay?J Dermatolog Treat 27, no. 4 (August 2016): 378–80. https://doi.org/10.3109/09546634.2015.1115815.
Johnson, M. G., et al. “Should all patients undergoing treatment with biologic agents be screened annually for latent tuberculosis infection with an interferon gamma release assay?J Dermatolog Treat, vol. 27, no. 4, Aug. 2016, pp. 378–80. Pubmed, doi:10.3109/09546634.2015.1115815.

Published In

J Dermatolog Treat

DOI

EISSN

1471-1753

Publication Date

August 2016

Volume

27

Issue

4

Start / End Page

378 / 380

Location

England

Related Subject Headings

  • Psoriasis
  • Mass Screening
  • Male
  • Latent Tuberculosis
  • Interferon-gamma Release Tests
  • Incidence
  • Humans
  • Dermatology & Venereal Diseases
  • Biological Factors
  • Aged, 80 and over