Conversia testelor-screening pentru tuberculoză în timpul terapiei biologice la pacienţii cu maladii articulare inflamatorii
Închide
Conţinutul numărului revistei
Articolul precedent
Articolul urmator
1021 9
Ultima descărcare din IBN:
2021-05-28 22:34
Căutarea după subiecte
similare conform CZU
616.72-002:615.37+616-002.5-07 (1)
Patologia organelor de locomoţie. Sistemul osos şi locomotor (469)
Medicamentele potrivit originii lor (477)
SM ISO690:2012
, , , , , , , , GARABAJIU (PAȘALÎ), Maria, ISTRATI, Valeriu, , , BANAGA, Corneliu. Conversia testelor-screening pentru tuberculoză în timpul terapiei biologice la pacienţii cu maladii articulare inflamatorii. In: Sănătate Publică, Economie şi Management în Medicină , 2018, nr. 1-2(75-76), pp. 45-49. ISSN 1729-8687.
EXPORT metadate:
Google Scholar
Crossref
CERIF

DataCite
Dublin Core
Sănătate Publică, Economie şi Management în Medicină
Numărul 1-2(75-76) / 2018 / ISSN 1729-8687 /ISSNe 2587-3873

Conversia testelor-screening pentru tuberculoză în timpul terapiei biologice la pacienţii cu maladii articulare inflamatorii

Conversion of tuberculosis screening tests during biological therapy in patients with inflammatory joint diseases

Kонверсия скрининговых тестов на туберкулез на фоне биологической терапии у пациентов с воспалительными заболеваниями суставов

CZU: 616.72-002:615.37+616-002.5-07

Pag. 45-49

1, 1, 1, 1, Garabajiu (Pașalî) Maria1, Istrati Valeriu1, 1, Banaga Corneliu2
 
1 Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“,
2 IMSP Institutul de Cardiologie
 
 
Disponibil în IBN: 8 iunie 2018


Rezumat

Recomandările actuale privind frecvenţa retestărilor pentru tuberculoza (TBC) latentă la pacienţii trataţi cu remedii biologice au vizat ţările cu incidenţă scăzută a TBC şi nu este cert dacă se pot aplica în populaţii cu prevalenţă înaltă. Scopul cercetării a fost determinarea ratei de conversie a testului QT TB-Gold pe parcursul tratamentului cu remedii biologice la pacienţii cu patologii inflamatorii articulare, pentru a determina frecvenţa oportună de efectuare a acestuia în condiţiile asistenţei medicale primare. Este un studiu prospectiv observaţional, cu includerea a două loturi de pacienţi: L1 – tratament cu anti-TNFα; L2 – tratament cu anti-IL6. Evaluarea în dinamică prin QT TB-Gold a presupus patru vizite: vizita baseline, 6, 12 şi 24 de luni. Parametrul principal de rezultat a fost rata de conversie a testului QT TB-Gold la 6, 12 şi 24 de luni. Aplicarea criteriilor de selecţie a rezultat prin formarea a două loturi: L1 – 24 pacienţi cu artrită psoriazică, tratament cu anti-TNFα; L2 – 23 pacienţi cu artrită reumatoidă, tratament cu anti-IL6. Rata de TB latentă la bolnavii cu maladii articulare inflamatorii a fost de 22,12%. Incidenţa cumulativă a conversiei QT TB-Gold a fost de 10,65% la 6 luni, 2,38% la 12 luni şi 4,87% la 24 de luni după iniţierea tratamentului biologic, fără diferenţe statistic semnificative între loturi. Odată cu iniţierea tratamentului biologic, se recomandă screeningul TBC latente prin QT TB-Gold la toţi pacienţii, iar retestarea bolnavilor din ţările cu o prevalenţă TBC înaltă se va efectua la 6 luni după debutul tratamentului, ulterior anual

Current recommendations on the frequency of retests for latent tuberculosis (TBC) in patients treated with biological drugs were based on studies in low TB incidence populations and it is unclear whether they can be applied to high prevalence populations. The purpose of the study was to determine the conversion rate of the QT TB-Gold test during the treatment with biological drugs in patients with joint inflammatory diseases, in order to determine the appropriate frequency for retest in primary care. Methods: prospective observational study in two groups of patients: G1 –anti-TNFα and G2 – anti-IL6 treatment. The QT TB-Goldwas retested within 4 visits: baseline visit, at 6, 12 and 24 months. The main outcome parameter was the conversion rate of the QT TB-Gold test at 6, 12 and 24 months. Applying the selection criteria resulted in the formation of 2 groups: G1 – 24 patients with psoriatic arthritis, treatment with anti-TNFα and G2 – 23 patients with rheumatoid arthritis, anti-IL6 treatment. The latent rate of TB in patients with inflammatory joint disease was 22.12%. The cumulative incidence of QT TB-Gold conversion was 10.65% at 6 months, 2.38% at 12 months and 4.87% at 24 months after initiation of biological treatment, with no statistically significant differences between groups. Screening for latent TBC, by QT TB-Gold, is recommended in all patients at the initiation of biological treatment. The frequency of the retesting patients from high TBC prevalence countries will be performed at 6 months after the initiation of treatment, then annually..  

Текущие рекомендации о частоте повторных тестов на латентный туберкулез (ТБ) у пациентов, получающих биологические средства, основаны на исследованиях, проведенных в странах с низкой заболеваемостью туберкулезом, и неясно, могут ли они быть применимы у населения с высокой частотой заболевания. Цель исследования состояла в определении коэффициента конверсии теста QT TB-Gold во время лечения биологическими препаратами пациентов с воспалительными заболеваниями суставов для установления необходимой частоты его повторного выполнения в условиях первичной медицинской помощи. Обсервационное исследование включило две группы пациентов: лечение L1 – препараты анти-TNFα и L2-ингибиторы IL6. Оценка QT TB-Gold требовала 4 посещений: базовый визит, 6, 12 и 24 месяца. Основным параметром определения был коэффициент конверсии теста QT TB-Gold на этих визитах. Применение критериев отбора привело к разграничению 2 лотов: L1 – 24 пациента с псориатическим артритом и лечением препаратами анти-TNFα и L2 –23 пациента с ревматоидным артритом и лечениемингибиторами IL6. Латентный уровень ТБ у пациентов с воспалительными заболеваниями суставов составил 22,12%. Кумулятивная частота конверсии QT TB-Gold составила 10,65% через 6 месяцев, 2,38% – 12 месяцев и 4,87% через 24 месяца после начала биологической терапии, без статистически значимых различий между лотами. При инициировании биологической терапии всем пациентам рекомендуется скрининг на латентный туберкулез QT TB-Gold, а повторный его анализ, у пациентов в странах с высокой распространенностью ТБ, должен проводится через 6 месяцев после начала лечения, а затем ежегодно.  

Cuvinte-cheie
tuberculoză latentă, QT TB-Gold, anti-TNFα, anti-IL6,

artrita psoriazică, artrita reumatoidă

Cerif XML Export

<?xml version='1.0' encoding='utf-8'?>
<CERIF xmlns='urn:xmlns:org:eurocris:cerif-1.5-1' xsi:schemaLocation='urn:xmlns:org:eurocris:cerif-1.5-1 http://www.eurocris.org/Uploads/Web%20pages/CERIF-1.5/CERIF_1.5_1.xsd' xmlns:xsi='http://www.w3.org/2001/XMLSchema-instance' release='1.5' date='2012-10-07' sourceDatabase='Output Profile'>
<cfResPubl>
<cfResPublId>ibn-ResPubl-62958</cfResPublId>
<cfResPublDate>2018-06-01</cfResPublDate>
<cfVol>75-76</cfVol>
<cfIssue>1-2</cfIssue>
<cfStartPage>45</cfStartPage>
<cfISSN>1729-8687</cfISSN>
<cfURI>https://ibn.idsi.md/ro/vizualizare_articol/62958</cfURI>
<cfTitle cfLangCode='RO' cfTrans='o'>Conversia testelor-screening pentru tuberculoză &icirc;n timpul terapiei biologice la pacienţii cu maladii articulare inflamatorii</cfTitle>
<cfKeyw cfLangCode='RO' cfTrans='o'>tuberculoză latentă; QT TB-Gold; anti-TNFα; anti-IL6; artrita psoriazică; artrita reumatoidă</cfKeyw>
<cfAbstr cfLangCode='RO' cfTrans='o'><p><em>Recomandările actuale privind frecvenţa retestărilor pentru tuberculoza (TBC) latentă la pacienţii trataţi cu remedii biologice au vizat ţările cu incidenţă scăzută a TBC şi nu este cert dacă se pot aplica &icirc;n populaţii cu prevalenţă &icirc;naltă. Scopul cercetării a fost determinarea ratei de conversie a testului QT TB-Gold pe parcursul tratamentului cu remedii biologice la pacienţii cu patologii inflamatorii articulare, pentru a determina frecvenţa oportună de efectuare a acestuia &icirc;n condiţiile asistenţei medicale primare. Este un studiu prospectiv observaţional, cu includerea a două loturi de pacienţi: L1 &ndash; tratament cu anti-TNF&alpha;; L2 &ndash; tratament cu anti-IL6. Evaluarea &icirc;n dinamică prin QT TB-Gold a presupus patru vizite: vizita baseline, 6, 12 şi 24 de luni. Parametrul principal de rezultat a fost rata de conversie a testului QT TB-Gold la 6, 12 şi 24 de luni. Aplicarea criteriilor de selecţie a rezultat prin formarea a două loturi: L1 &ndash; 24 pacienţi cu artrită psoriazică, tratament cu anti-TNF&alpha;; L2 &ndash; 23 pacienţi cu artrită reumatoidă, tratament cu anti-IL6. Rata de TB latentă la bolnavii cu maladii articulare inflamatorii a fost de 22,12%. Incidenţa cumulativă a conversiei QT TB-Gold a fost de 10,65% la 6 luni, 2,38% la 12 luni şi 4,87% la 24 de luni după iniţierea tratamentului biologic, fără diferenţe statistic semnificative &icirc;ntre loturi. Odată cu iniţierea tratamentului biologic, se recomandă screeningul TBC latente prin QT TB-Gold la toţi pacienţii, iar retestarea bolnavilor din ţările cu o prevalenţă TBC &icirc;naltă se va efectua la 6 luni după debutul tratamentului, ulterior anual</em></p></cfAbstr>
<cfAbstr cfLangCode='EN' cfTrans='o'><p><em>Current recommendations on the frequency of retests for latent tuberculosis (TBC) in patients treated with biological drugs were based on studies in low TB incidence populations and it is unclear whether they can be applied to high prevalence populations. The purpose of the study was to determine the conversion rate of the QT TB-Gold test during the treatment with biological drugs in patients with joint inflammatory diseases, in order to determine the appropriate frequency for retest in primary care. Methods: prospective observational study in two groups of patients: G1 &ndash;anti-TNF&alpha; and G2 &ndash; anti-IL6 treatment. The QT TB-Goldwas retested within 4 visits: baseline visit, at 6, 12 and 24 months. The main outcome parameter was the conversion rate of the QT TB-Gold test at 6, 12 and 24 months. Applying the selection criteria resulted in the formation of 2 groups: G1 &ndash; 24 patients with psoriatic arthritis, treatment with anti-TNF&alpha; and G2 &ndash; 23 patients with rheumatoid arthritis, anti-IL6 treatment. The latent rate of TB in patients with inflammatory joint disease was 22.12%. The cumulative incidence of QT TB-Gold conversion was 10.65% at 6 months, 2.38% at 12 months and 4.87% at 24 months after initiation of biological treatment, with no statistically significant differences between groups. Screening for latent TBC, by QT TB-Gold, is recommended in all patients at the initiation of biological treatment. The frequency of the retesting patients from high TBC prevalence countries will be performed at 6 months after the initiation of treatment, then annually..</em> &nbsp;</p></cfAbstr>
<cfAbstr cfLangCode='RU' cfTrans='o'><p><em>Текущие рекомендации о частоте повторных тестов на латентный туберкулез (ТБ) у пациентов, получающих биологические средства, основаны на исследованиях, проведенных в странах с низкой заболеваемостью туберкулезом, и неясно, могут ли они быть применимы у населения с высокой частотой заболевания. Цель исследования состояла в определении коэффициента конверсии теста QT TB-Gold во время лечения биологическими препаратами пациентов с воспалительными заболеваниями суставов для установления необходимой частоты его повторного выполнения в условиях первичной медицинской помощи. Обсервационное исследование включило две группы пациентов: лечение L1 &ndash; препараты анти-TNF&alpha; и L2-ингибиторы IL6. Оценка QT TB-Gold требовала 4 посещений: базовый визит, 6, 12 и 24 месяца. Основным параметром определения был коэффициент конверсии теста QT TB-Gold на этих визитах. Применение критериев отбора привело к разграничению 2 лотов: L1 &ndash; 24 пациента с псориатическим артритом и лечением препаратами анти-TNF&alpha; и L2 &ndash;23 пациента с ревматоидным артритом и лечениемингибиторами IL6. Латентный уровень ТБ у пациентов с воспалительными заболеваниями суставов составил 22,12%. Кумулятивная частота конверсии QT TB-Gold составила 10,65% через 6 месяцев, 2,38% &ndash; 12 месяцев и 4,87% через 24 месяца после начала биологической терапии, без статистически значимых различий между лотами. При инициировании биологической терапии всем пациентам рекомендуется скрининг на латентный туберкулез QT TB-Gold, а повторный его анализ, у пациентов в странах с высокой распространенностью ТБ, должен проводится через 6 месяцев после начала лечения, а затем ежегодно.</em> &nbsp;</p></cfAbstr>
<cfResPubl_Class>
<cfClassId>eda2d9e9-34c5-11e1-b86c-0800200c9a66</cfClassId>
<cfClassSchemeId>759af938-34ae-11e1-b86c-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfResPubl_Class>
<cfResPubl_Class>
<cfClassId>e601872f-4b7e-4d88-929f-7df027b226c9</cfClassId>
<cfClassSchemeId>40e90e2f-446d-460a-98e5-5dce57550c48</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfResPubl_Class>
<cfPers_ResPubl>
<cfPersId>ibn-person-40067</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-45345</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-14340</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-27145</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-53745</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-42495</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-11763</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
<cfPers_ResPubl>
<cfPersId>ibn-person-13527</cfPersId>
<cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId>
<cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPers_ResPubl>
</cfResPubl>
<cfPers>
<cfPersId>ibn-Pers-40067</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-40067-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-45345</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-45345-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-14340</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-14340-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-27145</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-27145-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-53745</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-53745-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
<cfFamilyNames>Garabajiu (Pașalî)</cfFamilyNames>
<cfFirstNames>Maria</cfFirstNames>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-42495</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-42495-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
<cfFamilyNames>Istrati</cfFamilyNames>
<cfFirstNames>Valeriu</cfFirstNames>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-11763</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-11763-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
</cfPersName_Pers>
</cfPers>
<cfPers>
<cfPersId>ibn-Pers-13527</cfPersId>
<cfPersName_Pers>
<cfPersNameId>ibn-PersName-13527-2</cfPersNameId>
<cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId>
<cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId>
<cfStartDate>2018-06-01T24:00:00</cfStartDate>
<cfFamilyNames>Banaga</cfFamilyNames>
<cfFirstNames>Corneliu</cfFirstNames>
</cfPersName_Pers>
</cfPers>
</CERIF>