Document Detail


Low prevalence of reactive PPD prior to infliximab use: comparative study on a population sample of Hospital Geral de Fortaleza.
MedLine Citation:
PMID:  21412605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify tuberculosis infection in rheumatic patients on infliximab by use of PPD testing prior to immunobiologic therapy.
METHODS: This study comprised 157 patients undergoing infliximab treatment and 734 other patients undergoing laboratory screening for tuberculosis infection originating from several services. The Mantoux technique was used for PPD testing, and an induration of at least 5 mm was considered reactive status.
RESULTS: In the infliximab group, 13% of the patients reacted to PPD, while, in the other group, 27% of the patients reacted to PPD (χ² = 13; P = 0.0003). These patients were divided into categories: adults with chronic diseases, PPD reactivity of 22%; and other controls, PPD reactivity of 31%. This shows the heterogeneous response of that population (χ² = 7; P < 0.009). In the infliximab group, subdivided according to pathologies [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PA)], different reactivity rates were observed, the lowest value occurring among RA patients: (RA x AS: OR = 0.13; CI: 0.03-0.47; χ ² = 12; P = 0.0004) and (RA x PA: OR = 0.16; CI: 0.02-1.04; χ² Yates corrected = 3.6; P = 0.05). The PPD reactivity in the RA subgroup (4%) was also lower as compared with that of the chronic patients group (22%) (OR = 0.16; CI: 0.05-0.49; χ² = 14; P = 0.0002), even when reclassified into four subgroups: rheumatology (OR = 0.19; CI: 0.04-0.72), kidney transplantation (OR = 0.16; CI: 0.05-0.51), infectology (OR = 0.21; CI: 0.05-0.75), and other conditions (OR = 0.13; CI: 0.04-0.44).
CONCLUSION: The low prevalence of PPD reaction in this Brazilian population, mainly in chronic patients, with the worst performance among RA patients, showed that the test has limited value for diagnosis of tuberculosis infection in candidates to infliximab therapy.
Authors:
Maria Roseli Monteiro Callado; José Rubens Costa Lima; Christiane Aguiar Nobre; Walber Pinto Vieira
Related Documents :
6974465 - Retained barium n the appendix: diagnostic and clinical significance.
16566935 - Impact of coasting in patients undergoing controlled ovarian stimulation with the gonad...
6209425 - Flow cytometric evaluation of sperm from patients with testicular carcinoma.
21751985 - P.tyr365cys change in factor viii: haemophilia a, but not as we know it.
10530735 - Hearing impairment in patients with acoustic neuroma--analysis by electrocochleography.
12743675 - Proprioceptive reflexes in patients with reflex sympathetic dystrophy.
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Revista brasileira de reumatologia     Volume:  51     ISSN:  1809-4570     ISO Abbreviation:  Rev Bras Reumatol     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-08-17     Revised Date:  2012-05-08    
Medline Journal Info:
Nlm Unique ID:  0404256     Medline TA:  Rev Bras Reumatol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  40-52     Citation Subset:  IM    
Affiliation:
Rheumatology Service of Hospital Geral de Fortaleza – HGF. Brazil. roselicallado@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / therapeutic use*
Antirheumatic Agents / therapeutic use*
Cross-Sectional Studies
Female
Hospitals, General
Humans
Male
Middle Aged
Prevalence
Retrospective Studies
Rheumatic Diseases / complications*,  drug therapy*
Tuberculin Test*
Tuberculosis / complications*,  diagnosis*,  epidemiology
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antirheumatic Agents; 0/Tumor Necrosis Factor-alpha; 0/infliximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Potential drug interactions in patients with rheumatoid arthritis.
Next Document:  Translation into Brazilian Portuguese and validation of the five-part questionnaire for identifying ...