Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry
Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry
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DOI：
10.1111/bjd.13539
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发表时间：
2015-06-01
影响因子：
10.3
通讯作者：
Naldi, L.
中科院分区：
文献类型：
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作者：
Gisondi, P.;Cazzaniga, S.;Naldi, L.
意大利银屑病患者潜伏性结核感染（LTBI）的全国患病率从未被调查过。目的评估意大利银屑病患者中LTBI的全国患病率，这些患者是系统治疗的候选者。方法数据来自Psocare登记处，（n = 4946）年龄> 18岁，入组时规定全身治疗，并根据Mantoux方法进行结核菌素皮肤试验（TST）。LTBI诊断是基于一个积极的TST结果在没有任何临床，放射学或微生物证据的活动性tuberculosis.Results潜伏性结核感染的银屑病患者（409 4946）的8.3%被诊断为。接受生物制剂治疗的患者中LTBI的患病率低于接受常规全身治疗的患者，范围从阿达木单抗治疗的4.3%（19/444）患者到接受长春新碱紫外线A治疗的31%（8/26）患者（P < 0.05）。与LTBI相关的独立因素为男性[比值比（OR）1.30，95%可信区间（CI）1.04-1.62; P = 0.02]、年龄> 55岁（OR 2.93，95% CI 2.18-3.93; P < 0.001）和进入常规治疗（OR 3.83，95% CI 3.10-4.74; P < 0.001）。结核病史阳性的1%的患者（n = 49）。结论LTBI在意大利银屑病患者的候选人全身治疗的全国患病率是高的，并建议筛选前的生物治疗。
Background The nationwide prevalence of latent tuberculosis infection (LTBI) in Italian patients with psoriasis has never been investigated.Objectives To estimate the nationwide prevalence of LTBI in Italian patients with psoriasis who are candidates for systemic treatment.Methods Data were obtained from the Psocare Registry on those patients (n = 4946) with age > 18 years, systemic treatment at entry specified and tuberculin skin test (TST) performed according to the Mantoux method. LTBI diagnosis was based on a positive TST result in the absence of any clinical, radiological or microbiological evidence of active tuberculosis.Results Latent tuberculosis infection was diagnosed in 8.3% of patients with psoriasis (409 of 4946). The prevalence of LTBI was lower in patients on biologics than in those on conventional systemic treatments, ranging from 4.3% (19 of 444) of patients on adalimumab to 31% (eight of 26) of those on psoralenultraviolet A (P < 0.05). Independent factors associated with LTBI were male sex [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.04-1.62; P = 0.02], age over 55 years (OR 2.93, 95% CI 2.18-3.93; P < 0.001) and being entered into a conventional treatment (OR 3.83, 95% CI 3.10-4.74; P < 0.001). Positive history of tuberculosis was seen in 1% of patients (n = 49).Conclusions The nationwide prevalence of LTBI in Italian patients with psoriasis candidate to systemic treatment is high, and screening is recommended prior to biological treatment.