Dynamic QuantiFERON response in psoriasis patients taking long-term biologic therapy

Lorenzo Drago, Lucia Nicola, Valentina Signori, Elisa Palazzi, Cecilia Garutti, Samantha Spadino, Gianfranco Altomare

Research output: Contribution to journalArticle

Abstract

Introduction: The risk of active tuberculosis is increased in psoriasis patients receiving biologic drug therapy.TheQuantiFERON-TBGoldIn-Tube assay (QFT) is used for latent tuberculosis screening in these patients. This study presents a retrospective analysis on repeated QFT assays, investigating the influence of biologic drugs and isoniazid therapy on the outcome of the assay. Methods: Serial QFTs of 58 psoriasis patients, who received biologic drug therapy, were evaluated at baseline and after 12 months of treatment. Patients were retrospectively divided in four groups according to QFT results at baseline and at follow-up: patients having a QFT reversion (from positive to negative results); patients with a conversion (from negative to positive); patients confirming the baseline results, either positive or negative. Results: At the end of the 12-months period, 11.1% of patients with a negative QFT result at baseline presented a conversion, showing low interferon (IFN)-gamma values, whereas 6.9% of positive patients presented a QFT reversion. When the test was repeated after 2-3 months without isoniazid chemoprophylaxis, patients with QFT conversion showed negative results. No patient developed active tuberculosis. Conclusions: In patients undergoing biologic therapy, a positive QFT assay needs to be further confirmed, as false-positive resultsmay occur after long-termtherapy. RepeatingQFT tests inpatients with low IFN-gamma values could reduce the incidence of false-positive latent tuberculosis infection diagnosis, thus preventing unnecessary tuberculosis chemoprophylaxis. In conclusion, a dynamic QFT response is possible in psoriasis patients undergoing biologic therapy.

Original languageEnglish
Pages (from-to)73-81
Number of pages9
JournalDermatology and Therapy
Volume3
Issue number1
DOIs
Publication statusPublished - 2013

Keywords

  • Biologic drugs
  • Chemoprophylaxis
  • Dermatology
  • False positive
  • Isoniazid
  • Psoriasis
  • QuantiFERON
  • Tuberculosis

ASJC Scopus subject areas

  • Dermatology

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  • Cite this

    Drago, L., Nicola, L., Signori, V., Palazzi, E., Garutti, C., Spadino, S., & Altomare, G. (2013). Dynamic QuantiFERON response in psoriasis patients taking long-term biologic therapy. Dermatology and Therapy, 3(1), 73-81. https://doi.org/10.1007/s13555-013-0020-3