{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T06:34:13Z","timestamp":1772519653998,"version":"3.50.1"},"reference-count":34,"publisher":"Korean Association for the Study of Intestinal Diseases","issue":"4","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2025IL0020"],"award-info":[{"award-number":["2025IL0020"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2023IT0006"],"award-info":[{"award-number":["2023IT0006"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["irjournal.org"],"crossmark-restriction":true},"short-container-title":["Intest Res"],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:p>Background\/Aims: We aimed to evaluate if using the interferon-gamma release assay (IGRA) alone is effective for latent tuberculosis infection (LTBI) screening in preventing active tuberculosis in patients with inflammatory bowel disease (IBD) before initiating anti-tumor necrosis factor alpha (anti-TNF-\u03b1) therapy, compared to using both the tuberculin skin test and IGRA.Methods: Using South Korea\u2019s Health Insurance Review and Assessment Service, we selected IBD patients treated with anti-TNF-\u03b1 agents for \u2265 1 year who underwent LTBI screening between 2018 and 2021. We compared the 1-year incidence rate and standardized incidence ratio of active tuberculosis incidence after starting anti-TNF-\u03b1 treatment to the general population based on the LTBI screening strategy.Results: Of the 4,215 enrolled patients, 3,505 underwent IGRA alone for LTBI screening, while 710 received both tuberculin skin test and IGRA. Within 1 year of starting anti-TNF-\u03b1 treatment, 15 patients (0.36%) developed active tuberculosis, with a mean follow-up period of 4,200.6 person-years. The 1-year tuberculosis incidence rates were 372.3 (95% confidence interval [CI], 198.2\u2013636.6) per 100,000 person-years for the IGRA alone group and 282.3 (95% CI, 34.2\u20131,019.9) per 100,000 person-years for the combination group. The standardized incidence ratios were similar: 14.34 (95% CI, 7.63\u201324.52) for the IGRA alone group and 11.25 (95% CI, 1.26\u201340.61) for the combination group. Conclusions: Using IGRA alone may be an effective strategy for LTBI screening in IBD patients before starting anti-TNF-\u03b1 therapy. 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