{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:39:29Z","timestamp":1783539569900,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anti\u2010tumor necrosis factor (anti\u2010TNF) therapy use in patients with inflammatory bowel disease (IBD) leads to an increased risk of tuberculosis (TB) reactivation despite latent tuberculosis (LTB) screening, especially in TB endemic regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We evaluated the effect of stringent screening strategy and LTB prophylaxis on TB reactivation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed an ambispective comparison between patients who received anti\u2010TNF therapy after January 2019 (late cohort) and between Jan 2005 and Jan 2019 (early cohort). Late cohort patients were subjected to stringent screening criteria which included all: history of past TB\/recent contact with active TB, chest X\u2010ray, CT (computed tomography) chest, IGRA (interferon\u2010gamma release assay), TST (tuberculin skin test), and if any positive were given chemoprophylaxis. A cohort comparison was done to evaluate for risk reduction of TB following the stringent screening strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred seventy\u2010one patients (63: ulcerative colitis\/108: Crohn\u2019s disease, mean age diagnosis: 28.5\u00a0\u00b1\u00a013.4\u00a0years, 60% males, median follow\u2010up duration after anti\u2010TNF: 33\u00a0months [interquartile range: 23\u201357\u00a0months]) were included. Among the 112 in the early cohort, 29 (26%) underwent complete TB screening, 22 (19.6%) had LTB, 10 (9%) received chemoprophylaxis, and 19 (17%) developed TB. In comparison, in the late cohort, 100% of patients underwent complete TB screening, 26 (44%) had LTB, 23 (39%) received chemoprophylaxis, and only 1(1.7%) developed TB (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). On survival analysis, patients in early cohort had a higher probability of TB reactivation compared with the late cohort (HR: 14.52 (95% CI: 1.90\u2013110.61 [<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01]) after adjusting for gender, age at anti\u2010TNF initiation, concomitant immunosuppression, anti\u2010TNF doses, and therapy escalation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The high risk of TB reactivation with anti\u2010TNF therapy in TB endemic regions can be significantly mitigated with stringent LTB screening and chemoprophylaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16839","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T13:29:43Z","timestamp":1646141383000},"page":"1431-1440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Stringent screening strategy significantly reduces reactivation rates of tuberculosis in patients with inflammatory bowel disease on <scp>anti\u2010TNF<\/scp> therapy in tuberculosis endemic region"],"prefix":"10.1111","volume":"55","author":[{"given":"Peeyush","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Human Nutrition All India Institute of Medical sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudheer K.","family":"Vuyyuru","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Human Nutrition All India Institute of Medical sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar","family":"Kante","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Human Nutrition All India Institute of Medical sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pabitra","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and 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