Rheumatoid Arthritis Clinical Trial
Official title:
Comparison of Quantiferon-TB Gold Assay With Tuberculin Skin Testing in the Assessment of Latent Mycobacterium Tuberculosis Infection in Patients Candidate to Treatment or Treated With TNFα Antagonists
The purpose of this study is to evaluate the value of Quantiferon-TB Gold (QFT-G) assay in the screening for latent tuberculosis infection (LTBI) in rheumatologic patients due to start or on treatment with TNFα antagonists. The results of QFT-G will be compared to tuberculin skin testing (TST) and correlated to clinical and demographic data. The study hypothesis is that the inclusion of QTF-G in the screening strategy will allow a more accurate assessment of LTBI infection.
Treatment with TNFα antagonists is associated with an increased risk of active tuberculosis.
Screening for LTBI and adherence to published guidelines have been shown to greatly decrease
the risk of active tuberculosis. However, the best screening strategy is still object of
debate. The validity of TST in patients on immunosuppressive treatment has been questioned.
Recently, interferon-γ assays based on RD1-specific antigens have shown to cause less
confounding by BCG vaccination and from most non-tuberculosis mycobacteria than TST, and
have shown improved accuracy over TST in several settings. However, data on their use in
rheumatologic patients are limited, and their superiority in patients on immunosuppressive
treatment is unclear since indeterminate results may limit their clinical usefulness in this
setting.
Purpose of the study is to investigate the added value of the inclusion of QTF-G assay in
the screening strategy of LTBI in rheumatologic patients before and during treatment with
TNFα antagonists.
The study will compare the results of TST with the results of QFT-G assay in rheumatologic
patients being evaluated for treatment with anti-TNFα agents or already on treatment with
anti-TNFα agents. The rate of positive and negative results of the two test will be
compared, end results correlated to clinical and demographic variables.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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