Positive conversion of latent tuberculosis screening in patients with inflammatory bowel disease on antitumor necrosis factor alpha drugs: a systematic review and meta-analysis.
Helio Rzetelna, Paula Santo, Heitor Siffert Pereira de Souza et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and single-arm meta-analysis assessed positive conversion on latent tuberculosis (TB) screening among patients with inflammatory bowel disease (IBD) receiving anti-TNF therapy after a negative baseline screen. Across 13 studies from nine countries, including 1153 patients, the pooled positive conversion rate was 9.20%. Rates varied by country, and meta-regression found a significant positive association between conversion and TB incidence. The authors conclude that conversion occurs during treatment and that prevention strategies should be individualized according to geographic location and risk factors.
Key findings
- Across 13 studies and 1153 patients, the overall positive conversion rate was 9.20%.
- Country-specific rates were 18.01% in Portugal, 4.51% in Spain, and 1.11% in the USA.
- Conversion was positively associated with TB incidence in meta-regression; subgroup differences were significant by country and consistency of screening test.
Why it matters
A positive screening result after a negative baseline test was observed in patients receiving anti-TNF therapy, with rates differing across settings. This highlights the relevance of local TB epidemiology and screening context when considering TB prevention in IBD patients on these drugs, while the pooled estimate does not establish an individual patient’s risk.
What to keep in mind
The analysis pooled single-arm studies, and conversion rates varied by country and by consistency of the screening test used, limiting the uniformity of the estimate.