Latent tuberculosis infection detection and active tuberculosis prevention in patients receiving anti-TNF therapy: an Italian nationwide survey

摘要: Aims Primary: to investigate Italian rheumatology practice regarding latent tubercular infection (LTBI) detection and tuberculosis (TB) prevention in patients requiring anti-tumor necrosis factor (anti-TNF) therapy. Secondary: assess the overall number of TB cases over 10 years their distribution by drug. Methods An anonymous, 24 multiple-response questionnaire was completed 393/449 (87.5%) rheumatologists prescribing anti-TNF Six questions provided setting information, 18 compliance with recommendations recorded cases. Results The were used 323 (82%) other sets 60 (15%). specialists always consulted 81 (21%) occasionally 73 (19%). LTBI screening made using chest radiograph (CR) 5%, tuburculin skin test (TST) 5.3%, CR + TST 35.6%, interferon-gamma release assay (IGRA) 7.4%, CR + IGRAs 26% CR + TST + IGRA 20.6%. Isoniazid initiated presence positivity TST 97 (24.7%), TST + IGRA 101 (25.7%) IGRA 195 (49.6%). Anti-TNF starting delay 1 month 63.1% cases, 3 months 27.7%, concomitantly 5.6%. Overall, 317 reactivation occurred 39 353 patients, an incidence rate 80.5 cases/100 000/year (10 times higher than general population). during prophylaxis 192 (60.6%). divided drug was: etanercept (ETN) 51 (16%), 28/100 000/year, adalimumab (ADA) 98 (31%), 89/100 000/year, infliximab (IFX) 137 (43.2%), 211/100 000/year, a significantly lower frequency ETN group compared ADA IFX groups (χ2 = P < 0.001). Conclusion Italian are highly aware anti-TNF-related risk variable strategies. outcome group.