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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 3/2014

01-03-2014 | Editorial

Effective Tuberculosis and Hepatitis Screening Prior to Anti-TNF-α Therapy: Are We There Yet?

Authors: Neal Shahidi, Brian Bressler

Published in: Digestive Diseases and Sciences | Issue 3/2014

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Excerpt

Anti-tumor necrosis factor-α (anti-TNF-α) drugs are widely used for the management of patients who suffer from Crohn’s disease (CD) and ulcerative colitis (UC). Screening for latent tuberculosis infection (LTBI) and hepatitis B virus (HBV) is mandatory prior to commencing therapy with anti-TNF-α drugs, due to an increased reactivation risk for these diseases. Unfortunately, in the case of LTBI, a consensus has not been reached, highlighted by the heterogeneity of current guidelines, regarding the use of the tuberculin skin test (TST) or an interferon-gamma release assay (IGRA) as parts of the initial screening strategy [1, 2]. …
Literature
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Rahier JF, Ben-Horin S, Chowers Y, et al. European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis. 2009;3:47–91.PubMedCrossRef
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Kucharz EJ, Korzeniewska-Kosela M, Kotulska A. Recommendations for prophylaxis and management of tuberculosis in patients treated with TNF-alpha antagonists. Reumatologia. 2008;46:51–54.
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Van der Have M, Oldenburg B, Fidder HH, et al. Optimizing screening for tuberculosis and hepatitis B prior to starting tumor necrosis factor-alpha inhibitors in Crohn’s disease. Dig Dis Sci. (Epub ahead of print). doi:10.​1007/​s10620-013-2820-9.
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Shahidi N, Fu YTN, Qian H, Bressler B. Performance of interferon-gamma release assays in patients with inflammatory bowel disease: a systematic review and meta-analysis. Inflamm Bowel Dis. 2012;18:2034–2042.PubMedCrossRef
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Pai M, Zwerling A, Menzies D. Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. Ann Intern Med. 2008;149:177–184.PubMedCentralPubMedCrossRef
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Sadatsafavi M, Shahidi N, Marra F, et al. A statistical method was used for the meta-analysis of tests for latent TB in the absence of a gold standard, combining random-effect and latent-class methods to estimate test accuracy. J Clin Epidemiol. 2010;63:257–269.PubMedCrossRef
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Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn’s disease: a diagnostic challenge. Am J Gastroenterol. 2009;104:1003–1012.PubMedCrossRef
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Metadata
Title
Effective Tuberculosis and Hepatitis Screening Prior to Anti-TNF-α Therapy: Are We There Yet?
Authors
Neal Shahidi
Brian Bressler
Publication date
01-03-2014
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 3/2014
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-013-2919-z

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