Evidence map›Paper›PMID 39272122›Full record

ArticleAdvances in rheumatology (London, England)2024

Tuberculin skin test repetition after TNF-α inhibitors in patients with chronic inflammatory arthritis: a long-term retrospective cohort in endemic area.

Vanessa de Oliveira Magalhães, Karina Rossi Bonfiglioli, Carina More Frade Gomes, Eloisa Bonfá, Ana Cristina de Medeiros-Ribeiro, Carla Gonçalves S Saad, Marcelo de Medeiros Pinheiro

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Article in Advances in rheumatology (London, England), 2024. 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
–field-weighted citation impact
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.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Vanessa de Oliveira MagalhãesSpondyloarthritis Section, Rheumatology Division, Federal University of São Paulo, (Unifesp/ EPM), Borges Lagoa Street, 913/ 51-53, Vila Clementino, São Paulo, SP, 04038-034, Brazil.ORCID 0000-0001-8662-4786
Karina Rossi BonfiglioliRheumatology DivisionHospital das Clínicas, Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil.ORCID 0000-0003-3547-5674
Carina More Frade GomesRheumatology Division, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil.
Eloisa BonfáRheumatology DivisionHospital das Clínicas, Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil.ORCID 0000-0002-0520-4681
Ana Cristina de Medeiros-RibeiroRheumatology DivisionHospital das Clínicas, Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil.ORCID 0000-0001-7168-5906
Carla Gonçalves S SaadRheumatology DivisionHospital das Clínicas, Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil.ORCID 0000-0001-9720-0719
Marcelo de Medeiros PinheiroSpondyloarthritis Section, Rheumatology Division, Federal University of São Paulo, (Unifesp/ EPM), Borges Lagoa Street, 913/ 51-53, Vila Clementino, São Paulo, SP, 04038-034, Brazil. mpinheiro@uol.com.br.ORCID 0000-0002-1896-8322

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the tuberculin skin test (TST) conversion in chronic inflammatory arthropathies (CIA) patients on TNFα inhibitors (TNFi) and without previous latent tuberculosis infection (LTBI) treatment.

methodsPatients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) with negative LTBI were retrospectively evaluated for TST conversion and active tuberculosis (TB) after six months of exposition to TNFi. Two groups were compared: patients who repeated TST (TST-repetition) during the follow-up and patients who did not (non-TST-repetition).

resultsA total of 355 CIA patients on TNFi were screened and 138 (38.9%) did not fulfill the inclusion criteria. Of the remaining 217 CIA patients, 81 (37.3%) repeated TST during TNFi treatment. TST conversion rate was observed in 18 (22.2%) patients without significant differences among CIA (p = 0.578). The number of TB cases was low (n = 10; 4.6%) and was similar in TST-repetition and non-TST-repetition groups [2 (2.5%) vs. 8 (5.9%), p = 0.328]. Of note, 30% of active TB occurred early (6-12 months of TNFi exposure) and the median (full range) time to incident TB was 1.3 (0.6-10.6) years, whereas the median (full range) time to TST repetition was later [3.3 (0.5-13.4) years]. The incidence of active TB was lower among RA patients than AS patients [342 (95% CI 41 - 1446) vs. 1.454 (95% CI 594-2993)/100,000 patient-years, p = 0.049].

conclusionThese results indicate that TST repetition is associated with a high conversion rate, suggesting the need for recommended treatment. The delayed repetition of TST and low number of active TB cases hampered the evaluation of this strategy effectiveness to prevent active infection. Larger studies with systematic repetition patterns are necessary. In addition, the study highlights the need for a greater surveillance for TB in AS patients.

Indexed as

Arthritis, PsoriaticArthritis, RheumatoidLatent TuberculosisSpondylitis, AnkylosingTuberculin TestTumor Necrosis Factor-alphaAdultAgedAntirheumatic AgentsCohort StudiesEndemic DiseasesFemaleHumansMaleMiddle AgedRetrospective StudiesAntirheumatic AgentsTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAnkylosing spondylitisChronic inflammatory arthritisLatent tuberculosis infectionPsoriatic arthritisRheumatoid arthritisTSTTST repetitionTuberculin skin testTuberculosis

Identifiers

PMID39272122
PMCPMC13488723

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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.