Ulcerative Colitis Clinical Trial
Official title:
The Role of Interferon Gamma Releasing Assays (IGRA) in Screening and Monitoring for Tuberculosis During Anti-TNF Therapy in Patients With Immune-mediated Inflammatory Disease (IMID)
Hong Kong is a region of intermediate TB burden, and the reactivation of latent TB in IMID patients treated with anti-TNF can be a serious problem. This study aims to investigate the role of IGRA in screening for latent TB in IBD patients and control subjects. In part II of the study, patients of other immune-mediated inflammatory diseases (IMID) will also be included to investigate the role of serial interferon-gamma release assays (IGRA) for the diagnosis of tuberculosis (TB) infection in patients with immune-mediated inflammatory diseases (IMID) treated with biologics
The incidence of inflammatory bowel disease is rising in Hong Kong. Anti-tumor necrosis
factor alpha (anti-TNF)-α is effective and increasingly being used for the treatment of
patients with refractory disease and complicated disease behaviour. The reactivation of
latent tuberculosis (TB) is a well-recognised complication associated with the use of
anti-TNF therapy, and most cases occurred in endemic regions. Hong Kong is a region of
intermediate TB burden, and the reactivation of latent TB in IMID patients treated with
anti-TNF can be a serious problem. Screening has been shown to reduce the incidence of TB,
but it remains unclear whether monitoring during anti-TNF therapy is effective. Despite
reported efficacy with the current screening strategy, active TB developed in up to 11.4% of
patients receiving anti-TNF therapy. There is therefore an urgent need for better disease
monitoring and prevention, particularly in regions where TB is endemic.
Part I of this study aims to investigate the role of IGRA in screening for latent TB in IBD
patients and control subjects. Part II of this study is a prospective study of serial
interferon-gamma release assays (IGRA) for the diagnosis of tuberculosis (TB) infection in
patients with immune-mediated inflammatory diseases (IMID) treated with biologics
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