Evidence map›Paper›PMID 33270676›Full record

Trial reportPloS one2020

TST conversions and systemic interferon-gamma increase after methotrexate introduction in psoriasis patients.

Vanessa Lucília Silveira de Medeiros, Fabiana Cristina Fulco Santos, Lílian Maria Lapa Montenegro, Maria da Conceição Silva, Valdênia Maria Oliveira de Souza, Reginaldo Gonçalvez de Lima Neto, Líbia Cristina Rocha Vilela Moura, Vera Magalhães

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 50% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Observational
  2. Review
  3. Article
  4. Article
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

8 authors at 1 institution in 1 country.

Vanessa Lucília Silveira de MedeirosDermatology Clinic, Clinics Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.ORCID 0000-0002-1445-587X
Fabiana Cristina Fulco SantosDepartment of Immunology, Laboratory of Immunoepidemiology, Aggeu Magalhães Research Center (CPqAM), Fiocruz, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Lílian Maria Lapa MontenegroDepartment of Immunology, Laboratory of Immunoepidemiology, Aggeu Magalhães Research Center (CPqAM), Fiocruz, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Maria da Conceição SilvaDepartment of Tropical Medicine, Clinics Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Valdênia Maria Oliveira de SouzaDepartment of Tropical Medicine, Clinics Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Reginaldo Gonçalvez de Lima NetoDepartment of Tropical Medicine, Clinics Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Líbia Cristina Rocha Vilela MouraDepartment of Tropical Medicine, Clinics Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Vera MagalhãesDepartment of Tropical Medicine, Clinics Hospital, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
Universidade Federal de Pernambuco · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberculosis screening in psoriasis patients is complex due to the immunological alterations associated with psoriasis, the presence of comorbidities, and the effect of immunosuppressive treatment. However, it is not established whether the results of screening tests are affected by these factors in psoriasis patients.

objectivesTo determine whether there is a change in the results of the tuberculin skin test (TST) or the interferon-gamma release assay (IGRA) in psoriasis patients living in tuberculosis (TB)-endemic area after 12 weeks of methotrexate (MTX) treatment and to investigate the association of the test results with clinical and inflammatory markers.

methodsForty-five patients were selected for a prospective single-arm self-controlled study and followed for at least 18 months. The TST, IGRA, Psoriasis Area and Severity Index (PASI), and inflammatory factors (erythrocyte sedimentation rate (ESR), C-reactive protein, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha levels), were determined before and after 12 weeks of oral 15 mg per week MTX administration and compared. The associations between the IGRA and TST results were verified before and after treatment according to inflammatory factors and clinical characteristics (age, blood glucose, weight, body mass index, disease duration, and PASI).

resultsWe collected data on 25 patients who completed the full course of therapy and the follow-up. None of the patients developed TB. TST positivity was significantly elevated at week 12 (25% baseline vs 44% at week 12, P < 0.037). Three IGRAs followed the TST conversions. There was no difference between TST and IGRA pre- or posttreatment. Serum IFN-γ increased significantly in week 12 (15.95 pg/ml baseline vs 18.82 pg/ml at week 12, P < 0.005) and tended to be higher among TST-positive patients (P = 0.072). The baseline IGRA was associated with a higher ESR (P = 0.038). None of the test results were associated with clinical characteristics.

conclusionsIn addition to the classic booster effect, TST conversions in patients using MTX can occur due to an increase in IFN-γ. However, it is not possible to exclude true TST conversions. Therefore, other diagnostic methods, like IGRA or chest tomography, should be used when the TST has intermediate results.

Indexed as

AdultC-Reactive ProteinFemaleHumansImmunosuppressive AgentsInterferon-gammaLatent TuberculosisMaleMass ScreeningMethotrexateMiddle AgedPsoriasisSeverity of Illness IndexTuberculin TestTumor Necrosis Factor-alphaYoung AdultC-Reactive ProteinIFNG protein, humanImmunosuppressive AgentsInterferon-gammaMethotrexateTumor Necrosis Factor-alpha

Identifiers

PMID33270676
PMCPMC7714364
OpenAlexW3107666426

What OpenQuestion holds

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LicenceCC BY
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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.