Published October 2016
| Version v1
Journal article
Negative Screening Does Not Rule Out the Risk of Tuberculosis in Patients with Inflammatory Bowel Disease Undergoing Anti-TNF Treatment: A Descriptive Study on the GETAID Cohort
Creators
- Abitbol, Yael
- Laharie, David
- Cosnes, Jacques
- Allez, Matthieu
- Nancey, Stephane
- Amiot, Aurelien
- Aubourg, Alexandre
- Fumery, Mathurin
- Altwegg, Romain
- Michetti, Pierre
- Chanteloup, Elise
- Seksik, Philippe
- Baudry, Clotilde
- Flamant, Mathurin
- Bouguen, Guillaume
- Stefanescu, Carmen
- Bourrier, Anne
- Bommelaer, Gilles
- Dib, Nina
- Bigard, Marc André
- Viennot, Stephanie
- Hebuterne, Xavier
- Gornet, Jean-Marc
- Marteau, Philippe
- Bouhnik, Yoram
- Abitbol, Vered
- Nahon, Stéphane
Contributors
Others:
- Service d'Hépato-Gastro-Entérologie ; CHU Bordeaux [Bordeaux]-Hôpital Saint-André
- Université Pierre et Marie Curie - Paris 6 (UPMC)
- Service de Gastroentérologie et nutrition [CHU Saint-Antoine] ; CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Hôpital Saint-Louis ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)
- Service d'hépato-gastroentérologie ; Hospices Civils de Lyon (HCL)
- Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) (EC2M3) ; Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
- Génétique, immunothérapie, chimie et cancer (GICC), UMR 7292 CNRS [2012-2017] (GICC UMR 7292 CNRS) ; Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)
- Service d'hépatogastroenterologie ; CHU Amiens-Picardie
- Hépato-gastro-entérologie ; Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
- Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV)
- Gastroenterology ; Saint-Louis Hospital
- Institut des Maladies de l'Appareil Digestif ; Université de Nantes (UN)
- Foie, métabolismes et cancer ; Université de Rennes 1 (UR1) ; Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
- CHU Pontchaillou [Rennes]
- Pole des maladies de l'appareil digestif, gastroentérologie et assistance nutritive ; Hôpital Beaujon [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Institut National de la Santé et de la Recherche Médicale (INSERM)
- Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH) ; Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA)
- Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH) ; Université d'Angers (UA)
- Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen] ; Université de Caen Normandie (UNICAEN) ; Normandie Université (NU)-Normandie Université (NU)-CHU Caen ; Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)
- Centre Hospitalier Universitaire de Nice (CHU de Nice)
- Université Nice Sophia Antipolis (1965 - 2019) (UNS) ; COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)
- CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Département de gastroentérologie ; Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Description
AIM: to describe the characteristics of incident cases of tuberculosis [TB] despite negative TB screening tests, in patients with inflammatory bowel disease [IBD] undergoing anti-TNF treatment, and to identify the risk factors involved. METHODS: A retrospective descriptive study was conducted at GETAID centers on all IBD patients undergoing anti-TNF treatment who developed TB even though their initial screening test results were negative. The following data were collected using a standardized anonymous questionnaire: IBD, and TB characteristics and evolution, initial screening methods and results, and time before anti-TNF treatment was restarted. RESULTS: A total of 44 IBD patients [including 23 men; median age 37 years] were identified at 20 French and Swiss centers at which TB screening was performed [before starting anti-TNF treatment] based on Tuberculin Skin Tests [n = 25], Interferon Gamma Release Assays [n = 12], or both [n = 7]. The median interval from the start of anti-TNF treatment to TB diagnosis was 14.5 months (interquartile range [IQR] 25-75: 4.9-43.3). Pulmonary TB involvement was observed in 25 [57%] patients, and 40 [91%] had at least one extrapulmonary location. One TB patient died as the result of cardiac tamponade. Mycobacterium tuberculosis exposure was thought to be a possible cause of TB in 14 cases [32%]: 7 patients [including 6 health care workers] were exposed to occupational risks, and 7 had travelled to endemic countries. Biotherapy was restarted on 27 patients after a median period of 11.2 months [IQR 25-75: 4.4-15.2] after TB diagnosis without any recurrence of the infection. CONCLUSION: Tuberculosis can occur in IBD patients undergoing anti-TNF treatment, even if their initial screening results were negative. In the present population, TB was mostly extrapulmonary and disseminated. TB screening tests should be repeated on people exposed to occupational risks and/or travelers to endemic countries. Restarting anti-TNF treatment seems to be safe.
Abstract
International audienceAdditional details
Identifiers
- URL
- https://hal-univ-rennes1.archives-ouvertes.fr/hal-01470713
- URN
- urn:oai:HAL:hal-01470713v1
Origin repository
- Origin repository
- UNICA