{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:26:49Z","timestamp":1773145609532,"version":"3.50.1"},"reference-count":22,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2018,3,20]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of this study was to determine the occurrence of latent tuberculosis infections (LTBI) and active TB in a cohort of patients with inflammatory bowel disease (IBD) treated with biologics. We also examined the effects of immunosuppressive drugs on indeterminate interferon-gamma release assays (IGRA) in LTBI screening.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective study of patients treated with biologics between March 2007 and November 2015.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>St Mark\u2019s Hospital, North West London, UK.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>732 patients with IBD who were screened for LTBI using either tuberculin skin test or IGRA before starting a biologic treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective case note review of all patients with IBD who were screened for LTBI prior to initiating biologics. Patients who developed active TB were identified from the London TB register.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 732 patients with IBD, 31 (4.2%) were diagnosed with and treated for LTBI with no significant side effects. Six of 596 patients (1.0%) who received biologic treatment developed active TB. There was a higher proportion of indeterminate IGRA in the immunosuppressive medication group compared with the non-immunosuppressive group (33% (59\/181) compared with 9% (6\/66), p&lt;0.001). The combination of steroids and thiopurines had the highest proportion of indeterminate IGRA (64%, 16\/25). High and low doses of steroids were equally likely to result in an indeterminate IGRA result (67% (8\/12) and 57% (4\/7), respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study highlights the challenges of LTBI screening prior to commencing biologic therapy and demonstrates the risk of TB in patients who have been screened and who are receiving prolonged and continuing doses of antitumour necrosis factor.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2017-100951","type":"journal-article","created":{"date-parts":[[2018,4,4]],"date-time":"2018-04-04T12:25:24Z","timestamp":1522844724000},"page":"234-240","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Challenges in screening for latent tuberculosis in inflammatory bowel disease prior to biologic treatment: a UK cohort study"],"prefix":"10.1136","volume":"9","author":[{"given":"Aye Aye","family":"Thi","sequence":"first","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St Mark\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aula","family":"Abbara","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Northwick Park Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Bouri","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St Mark\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon M","family":"Collin","sequence":"additional","affiliation":[{"name":"Bristol Medical School, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Wolfson","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St Mark\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Owen","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St Mark\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin G","family":"Buell","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"John","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Northwick Park Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ailsa L","family":"Hart","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St Mark\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,4,4]]},"reference":[{"key":"2025090708451940000_9.3.234.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011110"},{"key":"2025090708451940000_9.3.234.2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00028510"},{"key":"2025090708451940000_9.3.234.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.12.013"},{"key":"2025090708451940000_9.3.234.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.11.008"},{"key":"2025090708451940000_9.3.234.5","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207811"},{"key":"2025090708451940000_9.3.234.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2008.07.011"},{"key":"2025090708451940000_9.3.234.7","unstructured":"Brent Council. Joint Strategic Needs Assessment (JSNA): tuberculosis. 2015. https:\/\/www.brent.gov.uk\/jsna"},{"key":"2025090708451940000_9.3.234.8","unstructured":"Public Health England (PHE). Tuberculosis in England 2016 report (presenting data to end of 2015). 2016. https:\/\/www.gov.uk\/government\/publications\/tuberculosis-in-england-annual-report"},{"key":"2025090708451940000_9.3.234.9","doi-asserted-by":"crossref","first-page":"173","DOI":"10.3346\/jkms.2015.30.2.173","article-title":"The risk of tuberculosis in Korean patients with inflammatory bowel disease receiving tumor necrosis factor-\u03b1 blockers","volume":"30","author":"Byun","year":"2015","journal-title":"J Korean Med Sci"},{"key":"2025090708451940000_9.3.234.10","first-page":"241","article-title":"Latent tuberculosis screening tests and active tuberculosis infection rates in Turkish inflammatory bowel disease patients under anti-tumor necrosis factor therapy","volume":"28","author":"\u00c7eki\u00e7","year":"2015","journal-title":"Ann Gastroenterol"},{"key":"2025090708451940000_9.3.234.11","doi-asserted-by":"crossref","first-page":"3308","DOI":"10.3748\/wjg.v21.i11.3308","article-title":"Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents","volume":"21","author":"Kim","year":"2015","journal-title":"World J Gastroenterol"},{"key":"2025090708451940000_9.3.234.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.03.004"},{"key":"2025090708451940000_9.3.234.13","doi-asserted-by":"publisher","DOI":"10.1086\/595732"},{"key":"2025090708451940000_9.3.234.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02050.x"},{"key":"2025090708451940000_9.3.234.15","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000205"},{"key":"2025090708451940000_9.3.234.16","doi-asserted-by":"crossref","DOI":"10.1016\/S0016-5085(14)61350-0","article-title":"Su1101 indeterminate and inconclusive results are common when using interferon gamma release assay as screening for TB in patients with IBD","volume":"146","author":"Nasr","year":"2014","journal-title":"Gastroenterology"},{"key":"2025090708451940000_9.3.234.17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/381929","article-title":"Immunosuppression adversely affects TST but not IGRAs in patients with psoriasis or inflammatory musculoskeletal diseases","volume":"2012","author":"Tavast","year":"2012","journal-title":"Int J Rheumatol"},{"key":"2025090708451940000_9.3.234.18","first-page":"21","article-title":"Comparison of Quantiferon-TB Gold versus tuberculin skin test for tuberculosis screening in inflammatory bowel disease patients","volume":"22","author":"Andrisani","year":"2013","journal-title":"J Gastrointestin Liver Dis"},{"key":"2025090708451940000_9.3.234.19","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2005.046797"},{"key":"2025090708451940000_9.3.234.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0141033","article-title":"The significance of sensitive interferon gamma release assays for diagnosis of latent tuberculosis infection in patients receiving tumor necrosis factor-\u03b1 antagonist therapy","volume":"10","author":"Jung","year":"2015","journal-title":"PLoS One"},{"key":"2025090708451940000_9.3.234.21","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s13555-013-0020-3","article-title":"Dynamic QuantiFERON response in psoriasis patients taking long-term biologic therapy","volume":"3","author":"Drago","year":"2013","journal-title":"Dermatol Ther"},{"key":"2025090708451940000_9.3.234.22","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21824"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2017-100951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T15:45:34Z","timestamp":1757259934000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2017-100951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,4]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,6,7]]},"published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1136\/flgastro-2017-100951"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2017-100951","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"value":"2041-4137","type":"print"},{"value":"2041-4145","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,4]]}}}