Comparison of QuantiFERON-TB Gold and the tuberculin skin test for detecting previous tuberculosis infection evaluated by chest CT findings in Japanese rheumatoid arthritis patients

Maeda, Tomoyo; Banno, Shogo; Maeda, Shinji; Naniwa, Taio; Hayami, Yoshihito; Watanabe, Maiko; Ueda, Rieko; Sato, Shigeki

doi:10.1007/s10156-011-0250-1

Cited by 14 publications

(16 citation statements)

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“…False-positive tuberculin skin tests are more common in people with a past history of BCG vaccination, which has been common in Japan as a measure for tuberculosis prevention, ind t is difficult to detect previous tuberculosis infection by erythema size in people with a history of BCG. 14 This case shows the importance of tuberculosis prevention; appropriate screening tests should be used to avoid the unnecessary use of isoniazid therapy, which may cause ADRs such as liver damage. 15 IGRA has a higher specificity and sensitivity than the tuberculin skin test for the detection of reactivation of latent tuberculosis infection, 14 so IGRA should be used before adalimumab therapy to detect latent tuberculosis infections in patients with a history of BCG vaccination.…”

Section: Discussionmentioning

confidence: 93%

“…14 This case shows the importance of tuberculosis prevention; appropriate screening tests should be used to avoid the unnecessary use of isoniazid therapy, which may cause ADRs such as liver damage. 15 IGRA has a higher specificity and sensitivity than the tuberculin skin test for the detection of reactivation of latent tuberculosis infection, 14 so IGRA should be used before adalimumab therapy to detect latent tuberculosis infections in patients with a history of BCG vaccination.…”

Section: Discussionmentioning

confidence: 93%

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Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Ogata

Watanabe

Matsui

et al. 2016

ECCOJC

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Background and Aims:Data from an all-cases post-marketing study were used to evaluate the safety and effectiveness of adalimumab in Japanese patients with Crohn’s disease [CD].Methods:Patients received adalimumab for 24 weeks. Data from all patients [n = 1693] were used for the safety assessment. Data from patients with CD activity index [CDAI] ≥ 150 at baseline were used for the effectiveness assessment.Results:The most frequent serious adverse drug reaction [ADR] was infection and infestations [6.6 events/100 patient-years]. The risk of serious infections increased in patients who had a history of malignancy and those with concomitant corticosteroid use. Of 415 patients who had switched from another anti-tumour necrosis factor alpha [TNFα] agent to adalimumab due to ADRs, 7.2% discontinued due to ADRs to adalimumab. Ten of 13 patients with a history of tuberculosis [TB] received prophylactic medication, and none developed TB. TB developed in one patient with no history of TB or anti-TB prophylaxis. Remission rates were 41.3% and 32.4% at 4 and 24 weeks, respectively. Remission rates did not differ between patients with and without concomitant use of immunomodulators. Predictive variables for increased effectiveness were CDAI ≤ 220 and disease duration of ≤ 2 years. Perianal lesions and loss of response to previous anti-TNFα agents affected effectiveness.Conclusions:The most frequent serious ADR was infection. Adalimumab significantly reduced disease activity, without any unexpected ADRs. Development of active TB during adalimumab therapy can be prevented through TB screening and prophylaxis. In patients who switched from another anti-TNFα agent to adalimumab due to ADRs, adalimumab was well tolerated.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Ogata

Watanabe

Matsui

et al. 2016

ECCOJC

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“…Lew et al demonstrated that no diagnostic test has 100% sensitivity for TB diagnosis and suggested a combined diagnostic approach that includes TST, CXR, IGRA, and CT [29]. …”

Section: Discussionmentioning

confidence: 99%

Use of low-dose computed tomography to assess pulmonary tuberculosis among healthcare workers in a tuberculosis hospital

Chen

et al. 2017

Infect Dis Poverty

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BackgroundAccording to the World Health Organization, China is one of 22 countries with serious tuberculosis (TB) infections and one of the 27 countries with serious multidrug-resistant TB strains. Despite the decline of tuberculosis in the overall population, healthcare workers (HCWs) are still at a high risk of infection. Compared with high-income countries, the TB prevalence among HCWs is higher in low- and middle-income countries. Low-dose computed tomography (LDCT) is becoming more popular due to its superior sensitivity and lower radiation dose. However, there have been no reports about active pulmonary tuberculosis (PTB) among HCWs as assessed with LDCT. The purposes of this study were to examine PTB statuses in HCWs in hospitals specializing in TB treatment and explore the significance of the application of LDCT to these workers.MethodsThis study retrospectively analysed the physical examination data of healthcare workers in the Beijing Chest Hospital from September 2012 to December 2015. Low-dose lung CT examinations were performed in all cases. The comparisons between active and inactive PTB according to the CT findings were made using the Pearson chi-square test or the Fisher’s exact test. Comparisons between the incidences of active PTB in high-risk areas and non-high-risk areas were performed using the Pearson chi-square test. Analyses of active PTB were performed according to different ages, numbers of years on the job, and the risks of the working areas. Active PTB as diagnosed by the LDCT examinations alone was compared with the final comprehensive diagnoses, and the sensitivity and positive predictive value were calculated.ResultsA total of 1 012 participants were included in this study. During the 4-year period of medical examinations, active PTB was found in 19 cases, and inactive PTB was found in 109 cases. The prevalence of active PTB in the participants was 1.24%, 0.67%, 0.81%, and 0.53% for years 2012 to 2015. The corresponding incidences of active PTB among the tuberculosis hospital participants were 0.86%, 0.41%, 0.54%, and 0.26%. Most HCWs with active TB (78.9%, 15/19) worked in the high-risk areas of the hospital. There was a significant difference in the incidences of active PTB between the HCWs who worked in the high-risk and non-high-risk areas (odds ratio [OR], 14.415; 95% confidence interval (CI): 4.733 – 43.896). Comparisons of the CT signs between the active and inactive groups via chi-square tests revealed that the tree-in-bud, cavity, fibrous shadow, and calcification signs exhibited significant differences (P = 0.000, 0.021, 0.001, and 0.024, respectively). Tree-in-bud and cavity opacities suggest active pulmonary tuberculosis, whereas fibrous shadow and calcification opacities are the main features of inactive pulmonary tuberculosis. Comparison with the final comprehensive diagnoses revealed that the sensitivity and positive predictive value of the diagnoses of active PTB based on LDCT alone were 100% and 86.4%, respectively.ConclusionsHealthcare workers in tuberculosis hospi...

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“…CT is very useful when there is a disagreement between clinical and radiological findings and/or when imaging findings are equivocal or inconclusive 11,63 . Lew, et al 3 showed that no diagnostic test has a 100% sensitivity for TB diagnosis, suggesting a combined diagnostic approach including TST, CXR, IGRA, and CT 65 . Lew, et al 3 showed that no diagnostic test has a 100% sensitivity for TB diagnosis, suggesting a combined diagnostic approach including TST, CXR, IGRA, and CT 65 .…”

Section: Journal Of Rheumatologymentioning

confidence: 99%

Diagnostic Accuracy of Chest Radiography for the Diagnosis of Tuberculosis (TB) and Its Role in the Detection of Latent TB Infection: a Systematic Review

Piccazzo

Paparo

Garlaschi

2014

The Journal of Rheumatology Supplement

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In this systematic review we evaluate the role of chest radiography (CXR) in the diagnostic flow chart for tuberculosis (TB) infection, focusing on latent TB infection (LTBI) in patients requiring medical treatment with biological drugs. In recent findings, patients scheduled for immunomodulatory therapy with biologic drugs are a group at risk of TB reactivation and, in such patients, detection of LTBI is of great importance. CXR for diagnosis of pulmonary TB has good sensitivity, but poor specificity. Radiographic diagnosis of active disease can only be reliably made on the basis of temporal evolution of pulmonary lesions. In vivo tuberculin skin test and ex vivo interferon-γ release assays are designed to identify development of an adaptive immune response, but not necessarily LTBI. Computed tomography (CT) is able to distinguish active from inactive disease. CT is considered a complementary imaging modality to CXR in the screening procedure to detect past and LTBI infection in specific subgroups of patients who have increased risk for TB reactivation, including those scheduled for medical treatment with biological drugs.

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Comparison of QuantiFERON-TB Gold and the tuberculin skin test for detecting previous tuberculosis infection evaluated by chest CT findings in Japanese rheumatoid arthritis patients

Cited by 14 publications

References 20 publications

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Safety of Adalimumab and Predictors of Adverse Events in 1693 Japanese Patients with Crohn’s Disease

Use of low-dose computed tomography to assess pulmonary tuberculosis among healthcare workers in a tuberculosis hospital

Diagnostic Accuracy of Chest Radiography for the Diagnosis of Tuberculosis (TB) and Its Role in the Detection of Latent TB Infection: a Systematic Review

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