Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi-110029, India.
Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi-110029, India.
Curr Rev Clin Exp Pharmacol. 2021;16(4):350-356. doi: 10.2174/1574884715999201231201538.
The study was conducted to determine whether synthetic Disease-Modifying Anti Rheumatic Drugs (DMARDs) suppress the latency of Tuberculosis (TB) infection in Rheumatoid Arthritis (RA) patients along with other variables.
This was done through Tuberculin Skin Test (TST) using purified protein derivative (PPD) in a cohort of RA patients. The TST was taken positive when induration post-PPD injection was ≥ 5mm and negative or anergic when it was < 5mm. We included 100 patients (N = 100).
The prevalence of positive TST was 36%, while 64% presented a negative result. Negative TST was significantly associated with steroid usage (39.4%, 95% CI: 28.4%-51.4%). Anergic (TST negative) and non-anergic (TST positive) patients were separated into groups, and a new analysis was conducted with elaboration on DMARDs used.
The use of steroids was associated with TST negativity, The same is not true with use of methotrexate or other DMARDs. Thus TST should be interpreted with caution, especially before starting biologicals.
本研究旨在确定合成的疾病修饰抗风湿药物（DMARDs）是否会抑制类风湿关节炎（RA）患者潜伏性结核（TB）感染，同时还会考虑其他变量。
通过对 RA 患者进行结核菌素皮肤试验（TST）并用纯化蛋白衍生物（PPD）进行测试。PPD 注射后硬结≥5mm 时 TST 为阳性，硬结<5mm 时为阴性或无反应。我们共纳入了 100 名患者（N=100）。
TST 阳性的患病率为 36%，而 64%的患者 TST 结果为阴性。阴性 TST 与激素使用显著相关（39.4%，95%可信区间：28.4%-51.4%）。将无反应（TST 阴性）和有反应（TST 阳性）的患者分为两组，并对使用的 DMARDs 进行了新的分析。
激素的使用与 TST 阴性相关，而甲氨蝶呤或其他 DMARDs 的使用则并非如此。因此，在开始使用生物制剂之前，应谨慎解读 TST 结果。
