SERIAL QUANTIFERON-TB TEST SCREENING IN RHEUMATOLOGY PATIENTS DURING TUMOR NECROSIS FACTOR ALPHA INHIBITORS TREATMENT

Aim:Screening for latent tuberculosis infection (LTBI) prior to biological therapy are recommended. Although our country is in the moderate risk category for tuberculosis infection, our national data regarding the seroconversion rate of the tuberculosis test during the use of these drugs remains unclear. The aim of this study was to evaluate the risk of emerging LTBI in our patients during treatment with tumor necrosis factor-alpha inhibitors. Material and Methods:This study included 81 patients with rheumatic diseases who had negative baseline QuantiFERON-TB test. All patients were evaluated by a serial QuantiFERON-TB test during their treatments. The primary endpoint was to reveal the LTBI risk by serial testing, while secondary endpoints were to determine the factors associated with seroconversion. Results:A total of 81 patients were evaluated with serial QuantiFERON-TB testing for an average of 28.3 months. During the follow-up, positive conversion of QuantiFERON-TB was detected in 6 (7.4%) of 81 patients. In multivariate analysis, aging was found to be the only independent risk factor for positive seroconversion rate (p=0.01). Conclusion:In this study, which we conducted in a population where tuberculosis infection is relatively common, QuantiFERON-TB test seroconversion rate was found to be 7.4% during treatment with inhibitors. Five out of six patients who developed seroconversion were in the ankylosing spondylitis group. These results emphasize the importance of annual LTBI screening in both rheumatoid arthritis and spondyloarthritis patients receiving biological therapy.