Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on screening and treatment of tuberculosis infection in patients with inflammatory bowel disease

Gastroenterol Hepatol. 2021 Jan;44(1):51-66. doi: 10.1016/j.gastrohep.2020.04.006. Epub 2020 Aug 20.
[Article in English, Spanish]

Abstract

There is evidence that following the recommendations on screening and treatment of tuberculosis infection does not completely prevent the onset of tuberculosis in patients with inflammatory bowel disease. This fact, and the increasing use of new biologics and immunomodulators, has led the Spanish Group Working on Crohn's Disease and Ulcerative Colitis to update their recommendations for the prevention of tuberculosis in patients with inflammatory bowel disease. Diagnostic methods for latent tuberculosis infection, different scenarios in which screening is to be performed, strategies to reduce the risk of tuberculosis once biological treatment is initiated and chemoprophylaxis guidelines for latent tuberculosis infection are reviewed, as well as the management of active tuberculosis during biological treatment. Finally, there is a summary of the current recommendations within the paper and in an algorithm.

Keywords: Cribado; Enfermedad inflamatoria intestinal; Infección tuberculosa latente; Inflammatory bowel disease; Latent tuberculosis infection; Recomendaciones; Recommendations; Screening; Tuberculosis.

Publication types

  • Practice Guideline

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Colitis, Ulcerative / drug therapy*
  • Consensus*
  • Crohn Disease / drug therapy*
  • False Negative Reactions
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Interferon-gamma Release Tests
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / etiology
  • Latent Tuberculosis / prevention & control*
  • Radiography, Thoracic
  • Spain / epidemiology
  • Tuberculin Test
  • Tuberculosis / diagnosis
  • Tuberculosis / epidemiology
  • Tuberculosis / prevention & control
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha