Tuberculosis Screening in Patients with Psoriasis Receiving Biologic Therapy: A Retrospective Cohort Study

Snast, Igor; Bercovici, Einav; Avni, Tomer; Shitenberg, Dorit; Hodak, Emmilia; Pavlovsky, Lev

doi:10.2340/00015555-3007

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…Nowadays, TST (Mantoux test) has been substituted by IFN‐γ release assay (IGRA) such as QFT, which evaluates IFN‐γ production by T cells exposed to specific mycobacterial antigens. IGRA tests are considered more sensitive and specific (sensitivity 52%‐70%, sensibility 97%‐99%, and specificity 89%‐99%) than TST 4,5 …”

Section: Discussionmentioning

confidence: 99%

“…The aim of the screening before the treatment start and during the follow‐up is to detect a possible quiescent state of the Mycobacterium tuberculosis infection called latent tuberculosis infection (LTBI) 1 . Opportunistic infections reactivation, especially LTBI, is one of the main risks during biologic therapy, in particular with TNF‐α inhibitors 2‐4 . TNF‐α, an inflammatory cytokine that plays a central role in the pathogenesis of psoriasis, is also involved in the control of bacterial infections and granuloma formation to limit pathogens dissemination.…”

Section: Introductionmentioning

confidence: 99%

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QuantiFERON TB‐gold conversion rate among psoriasis patients under biologics: a 9‐year retrospective study

et al. 2020

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Background Tuberculosis (TB) screening is mandatory for psoriasis biologic treatment. However, evidences regarding TB screening results during biologic treatment are conflicting. Objectives The aim of this study is to evaluate the rate of QuantiFERON TB Gold test (QFT) conversion in psoriasis patients during biologics over time. Methods A 9‐year single center retrospective study was performed in order to evaluate the rate of QFT conversion in patients affected by moderate‐to‐severe plaque psoriasis under available biological therapies (anti‐TNF‐α, IL‐12/23, IL‐17). For each patient, demographic data, age, gender, comorbidities, previous psoriasis therapy, as well as ongoing treatment type were registered. Five‐hundred twenty‐six patients (61.2% male, with a mean age of 52.6 ± 13.9 years) treated with biologics were enrolled. Results QFT conversion occurred in 6.5% of patients over a mean treatment duration of 3.2 years. On average, QFT conversion occurred after 34.05 months of treatment. Anti‐TNF‐α drugs, and among them, adalimumab above all (35.5% of all cases), were the most commonly involved treatment during QFT conversion, followed by anti‐IL‐12/23 (17.6%) and anti‐IL‐17 (14.7%). However, differences among biologics class or single biologics (adalimumab, etanercept, infliximab, golimumab, certolizumab, ustekinumab, ixekizumab, secukinumab) did not approach statistical significance. Conclusions Annual TB screening is important in psoriasis patients under biologic treatment in order to avoid possible latent TB infection reactivation. Indeed, our data showed that even in a low TB prevalence country like Italy, QFT may convert over time in psoriasis patients under biologics in 6.5% of the cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

QuantiFERON TB‐gold conversion rate among psoriasis patients under biologics: a 9‐year retrospective study

et al. 2020

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“…Following removal of duplicates, we screened 8436 titles and abstracts, 815 of which were advanced to full-text review (Figure 1). We ultimately included 24 cohort studies meeting our eligibility criteria, 22 with data on treatment of psoriasis 14 -35 and 2 with data on treatment of atopic dermatitis. 36,37 We did not identify any case-control studies that met our eligibility criteria.…”

Section: Resultsmentioning

confidence: 99%

Safety of Systemic Medications Among Older Adults With Psoriasis and Atopic Dermatitis: A Systematic Review of Observational Studies

et al. 2021

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Background Psoriasis and atopic dermatitis are common among older adults (≥65 years old), but clinical trials often exclude that population. Objective To synthesize evidence from observational studies on the safety of systemic therapies (conventional or biologic) for psoriasis and atopic dermatitis among older adults in a systematic review. Methods We searched MEDLINE and EMBASE (inception to October 31, 2019) and included observational studies reporting adverse events among older people treated with systemic therapy for psoriasis or atopic dermatitis. Outcomes were death, hospitalization, emergency department visits, infections, major cardiovascular events, renal toxicity, hepatotoxicity, and cytopenias. We assessed study quality using the Newcastle-Ottawa Scale. Results We included 22 studies on treatment for psoriasis and 2 for atopic dermatitis. Most studies were small and non-comparative and 20 of 24 were low quality. Studies comparing safety between medications or medication classes or between older and younger adults did not show apparent differences but had wide confidence intervals around relative effect estimates. Heterogeneity of study design and reporting precluded quantitative synthesis. Conclusions There is scant evidence on the safety of conventional systemic and biologic medications for older adults with psoriasis or atopic dermatitis; older adults and their clinicians should be aware of this evidence gap.

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Tuberculosis Screening in Patients with Psoriasis Receiving Biologic Therapy: A Retrospective Cohort Study

Cited by 2 publications

References 8 publications

QuantiFERON TB‐gold conversion rate among psoriasis patients under biologics: a 9‐year retrospective study

QuantiFERON TB‐gold conversion rate among psoriasis patients under biologics: a 9‐year retrospective study

Safety of Systemic Medications Among Older Adults With Psoriasis and Atopic Dermatitis: A Systematic Review of Observational Studies

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