Yield and cost effectiveness of mycobacterial infection detection using a simple IGRA-based protocol in UK subjects with inflammatory bowel disease suitable for anti-TNFα therapy

摘要: Abstract Background and aims Testing for LTBI is recommended prior to anti-TNFα agents. This includes an assessment of TB risk factors, chest radiograph, interferon-gamma release assay alone or with concurrent Tuberculin skin testing. Here we review our experience cost-effectiveness using T-SPOT.TB IGRA detect mycobacterial infection in patients IBD suitable therapy. Methods was a single-centre, retrospective economic evaluation (compared British Thoracic Society guidance) 125 adult (90 naive, 35 established on anti-TNFα) tested IGRA. Results All subjects had normal radiographs no clinical evidence TB. 109 (87%) were BCG vaccinated. 27 (22%) all not immunomodulation at the time 66 (53%) taking thiopurines, 22 (18%)corticosteroids, (28%) One hundred twenty two (98%) negative result, (2%) positive results, one (1%) indeterminate A strategy guide preventative treatment produced cost savings £10.79 per person compared BTS guidance. Eighty eight percent naive group have subsequently received either infliximab adalimumab (median follow-up 24 months, IQR 18–30) cases disease occurring. Conclusions The use simple screening protocol incorporating place TST largely vaccinated population, many immunomodulatory agents, appears work well cost-effective service.