Son Chang-Nam, Jun Jae-Bum, Kim Jong-Heon, Sung Il-Hoon, Yoo Dae-Hyun, Kim Tae-Hwan
Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
J Korean Med Sci. 2014 Aug;29(8):1090-3. doi: 10.3346/jkms.2014.29.8.1090. Epub 2014 Jul 30.
We evaluated the utility of follow-up interferon-gamma release assays (IGRAs) for the diagnosis of reactivation of latent tuberculosis infection (LTBI) or new tuberculosis in ankylosing spondylitis (AS) patients receiving anti-tumor necrosis factor alpha (anti-TNFα). The study participants (n=127) had a negative IGRA screening before receiving anti-TNFα and were evaluated by follow-up IGRA. We retrospectively examined data of the subjects according to age, gender, tuberculosis prophylaxis, concomitant medications, IGRA conversion and anti-TNFα, including type and treatment duration. The median duration of anti-TNFα was 21.5 months, and the median age was 35.3 yr. Of the 127 patients, IGRA conversion was found in 10 patients (7.9%). There was no significant variation between IGRA conversion rate and any risk factors except for age. IGRA conversion rate was not significantly different between AS and rheumatoid arthritis (P=0.12). IGRA conversion was observed in AS patients receiving anti-TNFα in Korea. A follow-up IGRA test can be helpful for identifying LTBI or new tuberculosis in AS patients receiving anti-TNFα.
我们评估了随访干扰素-γ释放试验（IGRAs）在诊断接受抗肿瘤坏死因子α（抗TNFα）治疗的强直性脊柱炎（AS）患者中潜伏性结核感染（LTBI）再激活或新发结核病的效用。研究参与者（n = 127）在接受抗TNFα治疗前IGRA筛查为阴性，并通过随访IGRA进行评估。我们根据年龄、性别、结核病预防、合并用药、IGRA转换情况和抗TNFα（包括类型和治疗持续时间）对受试者的数据进行了回顾性检查。抗TNFα的中位治疗持续时间为21.5个月，中位年龄为35.3岁。在127例患者中，10例（7.9%）出现IGRA转换。除年龄外，IGRA转换率与任何危险因素之间均无显著差异。AS患者与类风湿关节炎患者的IGRA转换率无显著差异（P = 0.12）。在韩国接受抗TNFα治疗的AS患者中观察到了IGRA转换。随访IGRA检测有助于识别接受抗TNFα治疗的AS患者中的LTBI或新发结核病。
