Tumour necrosis factor α inhibitors: screening for tuberculosis infection in inflammatory bowel disease

Arun Gupta, Alan C Street and Finlay A Macrae
Med J Aust 2008; 188 (3): 168-170.
  • Arun Gupta1
  • Alan C Street2
  • Finlay A Macrae3

  • Royal Melbourne Hospital, Melbourne, VIC.


Competing interests:

None identified.

  • 1. Luo JL, Maeda S, Hsu LC, et al. Inhibition of NF-κB in cancer cells converts inflammation-induced tumor growth mediated by TNFα to TRAIL-mediated tumor regression. Cancer Cell 2004; 6: 297-305.
  • 2. ten Hove T, van Montfrans C, Peppelenbosch MP, van Deventer SJH. Infliximab treatment induces apoptosis of lamina propria T lymphocytes in Crohn’s disease. Gut 2002; 50: 206-211.
  • 3. Jarnerot G, Hertervig E, Friis-Liby I, et al. Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study. Gastroenterology 2005; 128: 1805-1811.
  • 4. Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353: 2462-2476.
  • 5. Hanauer SB, Sandborn WJ, Rutgeerts P, et al. Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I trial. Gastroenterology 2006; 130: 323-333; quiz 591.
  • 6. Sandborn WJ, Feagan BG, Stoinov S, et al. Certolizumab pegol for the treatment of Crohn’s disease. N Engl J Med 2007; 357: 228-238.
  • 7. Nesbitt A, Fossati G, Bergin M, et al. Mechanism of action of certolizumab pegol (CDP870): in vitro comparison with other anti-tumor necrosis factor α agents. Inflamm Bowel Dis 2007; 13: 1323-1332.
  • 8. Bongartz T, Sutton AJ, Sweeting MJ, et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 2006; 295: 2275-2285.
  • 9. Nathan DM, Angus PW, Gibson PR. Hepatitis B and C virus infections and anti-tumor necrosis factor-α therapy: guidelines for clinical approach. J Gastroenterol Hepatol 2006; 21: 1366-1371.
  • 10. Lavagna A, Bergallo M, Daperno M, et al. Infliximab and the risk of latent viruses reactivation in active Crohn’s disease. Inflamm Bowel Dis 2007; 13: 896-902.
  • 11. British Thoracic Society Standards of Care Committee. BTS recommendations for assessing risk and for managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNF-α treatment. Thorax 2005; 60: 800-805.
  • 12. Dye C, Scheele S, Dolin P, et al. Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. JAMA 1999; 282: 677-686.
  • 13. Perez JL, Kupper H, Spencer-Green GT. Impact of screening for latent TB before initiating anti-TNF therapy in North America and Europe. Ann Rheum Dis 2005; 64 Suppl 3: 265.
  • 14. Carmona L, Gomez-Reino JJ, Rodriguez-Valverde V, et al. Effectiveness of recommendations to prevent reactivation of latent tuberculosis infection in patients treated with tumor necrosis factor antagonists. Arthritis Rheum 2005; 52: 1766-1772.
  • 15. Mow WS, Abreu-Martin MT, Papadakis KA, et al. High incidence of anergy in inflammatory bowel disease patients limits the usefulness of PPD screening before infliximab therapy. Clin Gastroenterol Hepatol 2004; 2: 309-313.
  • 16. Mazurek GH, Jereb J, Lobue P, et al. Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep 2005; 54 (RR-15): 49-55.
  • 17. Oxford Immunotec [website]. (accessed Dec 2007).
  • 18. Menzies D, Pai M, Comstock G. Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med 2007; 146: 340-354.
  • 19. Rangaka MX, Diwakar L, Seldon R, et al. Clinical, immunological, and epidemiological importance of antituberculosis T cell responses in HIV-infected Africans. Clin Infect Dis 2007; 44: 1639-1646.
  • 20. Piana F, Codecasa LR, Cavallerio P, et al. Use of a T-cell-based test for detection of tuberculosis infection among immunocompromised patients. Eur Respir J 2006; 28: 31-34.
  • 21. Matulis G, Jüni P, Villiger PM, Gadola SD. Detection of latent tuberculosis in immunosuppressed patients with autoimmune diseases: performance of a Mycobacterium tuberculosis antigen-specific interferon γ assay. Ann Rheum Dis 2008: 67: 84-90.
  • 22. Pai M, Lewinsohn DM. Interferon-γ assays for tuberculosis: is anergy the Achilles’ heel? Am J Respir Crit Care Med 2005; 172: 519-521.
  • 23. Winthrop KL. Risk and prevention of tuberculosis and other serious opportunistic infections associated with the inhibition of tumor necrosis factor. Nat Clin Pract Rheumatol 2006; 2: 602-610.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.