Intest Res.  2018 Jan;16(1):17-25. 10.5217/ir.2018.16.1.17.

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 2: management

  • 1Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2The Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
  • 3Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • 4Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
  • 5Gleneagles Medical Centre and Duke-NUS Medical School, Singapore, Singapore.
  • 6Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
  • 7Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
  • 8Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  • 9Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • 10Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
  • 11Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
  • 12Department of Gastroenterology, Shanghai Jiao Tong University, Shanghai, China.
  • 13Department of Gastroenterology, Fourth Military Medical University, Xi'an, China.
  • 14Department of Gastroenterology, Peking Union Medical College, Beijing, China.
  • 15Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
  • 16Department of Gastroenterology, Shiga University, Otsu, Japan.
  • 17Department of Internal Medicine, Toho University, Sakura, Japan.
  • 18Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
  • 19Center for Advanced IBD Research and Treatment, Kitasato University, Tokyo, Japan.
  • 20Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
  • 21Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.


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 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after 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.


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

MeSH Terms

Asian Continental Ancestry Group*
Committee Membership
Evaluation Studies as Topic
Inflammatory Bowel Diseases*
Risk Assessment
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