Abstract：
We aimed to obtain the effects of immunosuppressive doses on the QuantiFERON-TB Gold Plus (QFT-Plus) test results in Rheumatoid Arthritis (RA) patients. Besides this, the impact of the TB2 tube in QFT-Plus test was also investigated. This study included RA patients registered to HURBIO and were screened via QFT-Plus test for latent tuberculosis between January 2018 and March 2021, before the initiation of treatment of biologic/targeted-synthetic disease modifying anti-rheumatismal drugs (b/ts-DMARDs). Patients using methotrexate ≥ 10 mg or leflunomide (any dose) or steroids (≥ 7.5 mg prednisolone) at the time of QFT-Plus test were classified as the \"high dose\" group and the rest of the patients constituted the \"low dose\" group. The study included 534 RA patients; 353 [66.1%] in the high-dose group and 181 [33.9%] in the low-dose group. While QFT-Plus test was positive in 10.5% (37/353) patients in the high-dose group, it was positive in 20.4% (37/181) patients in the low-dose group (p < 0.001). The percentage of QFT-Plus indeterminate results were similar (around 2%) in both groups. The contribution of the TB2 tube to QFT-Plus test positivity was 6.89%. During a median (inter-quartile range) follow-up period of 23 (7-38) months under treatment of b/ts-DMARDs, latent TB reactivation was not observed. Primer active tuberculosis disease developed in two patients. Positive test results of Interferon-Gamma Release Assays (IGRAs) could decrease as immunosuppressive treatment doses increase in patients with RA and addition of the TB2 tube could increase test sensitivity.
摘要：
我们旨在获得免疫抑制剂量对类风湿性关节炎（RA）患者QuantiFERON-TBGoldPlus（QFT-Plus）测试结果的影响。除此之外,还研究了TB2管在QFT-Plus试验中的影响。这项研究包括登记在HURBIO的RA患者，并在2018年1月至2021年3月之间通过QFT-Plus测试筛查潜伏性结核病，然后开始治疗生物/靶向合成疾病改善抗风湿药（b/ts-DMARDs）。在QFT-Plus试验时使用甲氨蝶呤≥10mg或来氟米特（任何剂量）或类固醇（≥7.5mg泼尼松龙）的患者被归类为“高剂量”组，其余患者构成“低剂量”组。该研究包括534例RA患者；高剂量组353例[66.1%]，低剂量组181例[33.9%]。虽然高剂量组患者的QFT-Plus试验为10.5%(37/353)，低剂量组20.4%(37/181)的患者呈阳性(p<0.001).两组中QFT-Plus不确定结果的百分比相似（约2％）。TB2管对QFT-Plus试验阳性的贡献为6.89%。在b/ts-DMARDs治疗的23（7-38）个月的中位（四分位数范围）随访期间，未观察到潜伏性TB再激活。两名患者发生了引物活动性结核病。随着RA患者免疫抑制治疗剂量的增加，干扰素-γ释放试验（IGRAs）的阳性测试结果可能会降低，并且添加TB2管可增加测试灵敏度。
