https://scholars.lib.ntu.edu.tw/handle/123456789/592058
標題: | Serial QuantiFERON-TB Gold testing in patients with psoriasis treated with ustekinumab | 作者: | Hsiao C.-Y. HSIEN-YI CHIU Wang T.-S. TSEN-FANG TSAI |
公開日期: | 2017 | 出版社: | Public Library of Science | 卷: | 12 | 期: | 9 | 來源出版物: | PLoS ONE | 摘要: | Background: There is increasing concern about the risk of latent tuberculosis infection (LTBI) reactivation during the use of biologics for psoriasis. Although ustekinumab had been documented with low risk of tuberculosis, the long-term follow-up of LTBI as determined by QuantiFERON-TB Gold (QFT-G) testing in patients treated with ustekinumab is limited. Objectives: This study aims to use serial QFT-G testing as a screening method for detecting LTBI in patients with psoriasis from an intermediate tuberculosis burden country. Methods: This retrospective review investigated 134 psoriatic patients in whom ustekinumab was prescribed for at least one year between 2010 and 2016 in National Taiwan University Hospital. All patients underwent annular QFT-G testing during ustekinumab therapy. Results: Among the 134 enrolled patients, baseline LTBI rate was 13.4% (18/134). Indeterminate QFT-G result was noted in 5.2% (7/134) of patients and 71.4% (5/7) of them turn to be QFT-G negative during the next testing. 81.3% (109/134) of patients had a negative QFT-G at baseline and the seroconversion rate was 7.3% (8/109) in the serial QFT-G. All the patients in the conversion group were referred to a pulmonologist for evaluation and 81.5% (22/27) of them underwent chemoprophylactic therapy while on ustekinumab. No active TB infection was noted during further follow-up with or without chemoprophylaxis. Conclusions: This study revealed that psoriatic patients receiving long-term ustekinumab therapy had a low QFT-G conversion rate (7.3%). The clinical significance of QFT-G conversion remains controversial and needs larger scale trials to investigate. ? 2017 Hsiao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85029378674&doi=10.1371%2fjournal.pone.0184178&partnerID=40&md5=217f57496d968cd61e57e6e0708160eb https://scholars.lib.ntu.edu.tw/handle/123456789/592058 |
ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0184178 | SDG/關鍵字: | adalimumab; etanercept; isoniazid; methotrexate; tuberculostatic agent; ustekinumab; dermatological agent; gamma interferon; ustekinumab; adult; Article; disease burden; female; follow up; human; latent tuberculosis; long term care; major clinical study; male; Mycobacterium tuberculosis test kit; prescription; prevalence; psoriasis; retrospective study; screening test; seroconversion; Taiwan; treatment outcome; treatment response; university hospital; blood; combination drug therapy; complication; interferon gamma release assay; latent tuberculosis; middle aged; procedures; psoriasis; tuberculin test; Adult; Dermatologic Agents; Drug Therapy, Combination; Female; Humans; Interferon-gamma; Interferon-gamma Release Tests; Latent Tuberculosis; Male; Middle Aged; Psoriasis; Retrospective Studies; Treatment Outcome; Tuberculin Test; Ustekinumab |
顯示於: | 醫學系 |
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