Evidence map›Paper›PMID 30046428›Full record

ArticleFrontline gastroenterology2018

Challenges in screening for latent tuberculosis in inflammatory bowel disease prior to biologic treatment: a UK cohort study.

Aye Aye Thi, Aula Abbara, Sonia Bouri, Simon M Collin, Paul Wolfson, Leah Owen, Kevin G Buell, Laurence John, Ailsa L Hart

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontline gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
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  5. Review
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  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Aye Aye ThiInflammatory Bowel Disease Unit, St Mark's Hospital, London, UK.
Aula AbbaraDepartment of Infectious Diseases, Northwick Park Hospital, London, UK.
Sonia BouriInflammatory Bowel Disease Unit, St Mark's Hospital, London, UK.
Simon M CollinBristol Medical School, University of Bristol, Bristol, UK.
Paul WolfsonInflammatory Bowel Disease Unit, St Mark's Hospital, London, UK.
Leah OwenInflammatory Bowel Disease Unit, St Mark's Hospital, London, UK.
Kevin G BuellDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Laurence JohnDepartment of Infectious Diseases, Northwick Park Hospital, London, UK.
Ailsa L HartInflammatory Bowel Disease Unit, St Mark's Hospital, London, UK.
St Mark's Hospital · GBNorthwick Park Hospital · GBBristol Regional Medical Center · USImperial College London · GBSt. Mark's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to determine the occurrence of latent tuberculosis infections (LTBI) and active TB in a cohort of patients with inflammatory bowel disease (IBD) treated with biologics. We also examined the effects of immunosuppressive drugs on indeterminate interferon-gamma release assays (IGRA) in LTBI screening.

designRetrospective study of patients treated with biologics between March 2007 and November 2015.

settingSt Mark's Hospital, North West London, UK. PATIENTS: 732 patients with IBD who were screened for LTBI using either tuberculin skin test or IGRA before starting a biologic treatment.

methodsRetrospective case note review of all patients with IBD who were screened for LTBI prior to initiating biologics. Patients who developed active TB were identified from the London TB register.

resultsOf 732 patients with IBD, 31 (4.2%) were diagnosed with and treated for LTBI with no significant side effects. Six of 596 patients (1.0%) who received biologic treatment developed active TB. There was a higher proportion of indeterminate IGRA in the immunosuppressive medication group compared with the non-immunosuppressive group (33% (59/181) compared with 9% (6/66), p<0.001). The combination of steroids and thiopurines had the highest proportion of indeterminate IGRA (64%, 16/25). High and low doses of steroids were equally likely to result in an indeterminate IGRA result (67% (8/12) and 57% (4/7), respectively).

conclusionsThis study highlights the challenges of LTBI screening prior to commencing biologic therapy and demonstrates the risk of TB in patients who have been screened and who are receiving prolonged and continuing doses of antitumour necrosis factor.

Indexed as

crohn’s diseaseibdinfliximabulcerative colitis

Identifiers

PMID30046428
PMCPMC6056083
OpenAlexW2796072037

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.