Intest Res.  2018 Jan;16(1):4-16. 10.5217/ir.2018.16.1.4.

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment

• Park DI
• Hisamatsu
• Chen M
• Ng SC
• Ooi CJ
• Wei SC
• Banerjee R
• Hilmi IN
• Jeen YT
• Han DS
• Kim HJ
• Ran Z
• Wu K
• Qian J
• Hu PJ
• Matsuoka K
• Andoh A
• Suzuki Y
• Sugano K
• Watanabe M
• Hibi T
• Puri AS
• Yang SK

• KMID: 2402642
• DOI: http://doi.org/10.5217/ir.2018.16.1.4

Abstract

Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.

Keyword

Tuberculosis; Anti-tumor necrosis factor; Inflammatory bowel disease; Consensus statement

MeSH Terms

Asia*
Asian Continental Ancestry Group*
Colitis*
Committee Membership
Consensus*
Evaluation Studies as Topic
Gastroenterology*
Humans
Inflammatory Bowel Diseases*
Mass Screening
Mortality
Necrosis*
Politics
Risk Assessment*
Specialization
Tuberculosis*

Figure

• 

  Fig. 1 Algorithm for the diagnosis of latent tuberculosis infection in patients with IBD. Blue arrow, if a history of BCG vaccination is present; red arrow, start with tuberculin skin test (TST); green arrow, start with interferon-gamma releasing assay (IGRA). LTBI, latent tuberculosis infection.

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