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Steroids Decrease Prevalence of Positive Tuberculin Skin Test in Rheumatoid Arthritis: Implications on Anti-TNF
Shweta Agarwal1, Siddharth Kumar Das1, Girdhar G Agarwal2
1Department of Rheumatology, King George Medical University, Lucknow, Uttar Pradesh 226018, India.
Interdisciplinary Perspectives on Infectious Diseases
|April 8, 2014
Summary
Tuberculin skin test positivity is low in Rheumatoid Arthritis patients. Recent steroid use significantly reduces positive tuberculin skin test results, impacting latent tuberculosis screening before biologicals.
Area of Science:
- Rheumatology
- Infectious Disease
- Immunology
Background:
- Tuberculin skin test (TST) screens for latent tuberculosis in Rheumatoid Arthritis (RA) patients before biological therapy.
- Understanding the impact of RA treatments on TST is crucial for accurate interpretation.
Purpose of the Study:
- To determine the prevalence of positive TST in RA patients.
- To evaluate the effect of Disease-modifying antirheumatic drugs (DMARDs) and steroids on TST results.
Main Methods:
- Cross-sectional study of 250 RA patients (≥18 years) diagnosed by 1987 ACR criteria.
- Data collected on demographics, disease activity, duration, and therapy.
- All participants underwent TST.
Main Results:
- Overall TST positivity rate was 20.4% (51/250 patients).
- Methotrexate (MTX) intake did not affect TST results.
- Recent steroid use (within 3 months) significantly lowered TST positivity (3% vs. 25%, P=0.002).
Conclusions:
- The prevalence of latent tuberculosis, indicated by TST, is low in RA patients.
- Methotrexate does not influence TST outcomes.
- Recent corticosteroid therapy can lead to false-negative TST results in RA patients.
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