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亚洲克罗恩病和结肠炎组织与亚太胃肠病学会关于接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的共识。第 1 部分:风险评估。

Asian Organization for Crohn's and Colitis and Asian Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: Risk assessment.

机构信息

Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Korea.

The Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.

出版信息

J Gastroenterol Hepatol. 2018 Jan;33(1):20-29. doi: 10.1111/jgh.14019.

Abstract

Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asian Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection, and prevention of latent TB infection and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from nine Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised two parts: (i) risk of TB infection during anti-TNF therapy and (ii) screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

摘要

由于抗肿瘤坏死因子(anti-TNF)治疗在许多亚洲国家越来越受欢迎,因此,TNF 使用者发生活动性结核病(TB)的风险可能会给该地区带来严重的健康问题。因此,亚洲克罗恩病和结肠炎组织以及亚太胃肠病学会制定了一套关于炎症性肠病(IBD)患者接受抗 TNF 治疗时潜伏性结核感染的风险评估、检测和预防以及活动性 TB 感染管理的共识声明。最初起草了 23 条共识声明,然后由委员会成员进行讨论。使用推荐评估、制定和评估方法学(Grading of Recommendations Assessment, Development, and Evaluation methodology)评估证据质量和推荐强度。来自亚洲九个国家的 211 名 IBD 专家就每个声明进行了基于网络的共识投票。如果至少 75%的参与者同意,则接受共识声明。声明的第一部分包括两部分:(i)抗 TNF 治疗期间的 TB 感染风险,以及(ii)开始抗 TNF 治疗前的 TB 感染筛查。这些共识声明将通过降低接受抗 TNF 治疗的 IBD 患者与 TB 感染相关的发病率和死亡率,帮助临床医生优化患者的治疗效果。

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