Recently, Professor Zeng Xiaofeng and Professor Tian Xinping’s team from the Department of Rheumatology at PUMCH published a prospective cohort study on the incidence and risk factors for active tuberculosis infection (ATB) and changes of interferon-γ release assay (IGRA) in patients with Takayasu arteritis (TAK) in the journal “Emerging Microbes & Infections” (IF: 13.2). This study has provided a reference and basis for clinical diagnosis and treatment, thus garnering widespread attention. The research was supported by CAMS Innovation Fund for Medical Sciences (CIFMS) and the National High Level Hospital Clinical Research Funding.

Takayasu arteritis (TAK) is a chronic granulomatous vasculitis that occurs most commonly in Asian young females and primarily affects the aorta and its major branches. The association between tuberculosis (TB) and TAK has long been suspected but there lacks high-quality evidence to support this assumption. In addition, it is believed that immunosuppressive agents used to treat TAK could increase the risk of tuberculosis infection or re-activation of latent tuberculosis infection (LTBI). IGRA has been recommended by some academic organizations as a screening and monitoring tool for LTBI. However, the effectiveness of using IGRA as a monitoring tool for the occurrence of ATB and LTBI re-activation in patients treated with immunosuppressive agents and glucocorticoids (GCs) remains controversial.

▲This is a single-center, prospective cohort study

It is the clinical study with the largest sample worldwide to date on the risk of TB occurrence in TAK patients treated with GCs combined with conventional immunosuppressive agents or biologics. For the first time, this study used standardized incidence ratios. It revealed that the overall incidence rate of ATB was 6 times as high as that for the general adult population of China, indicating a clear association between TAK and TB occurrence. GCs and conventional immunosuppressive agents did not increase the risk of ATB or LTBI re-activation in TAK patients. However, the use of tumor necrosis factor inhibitor (TNFi) increased the risk of LTBI re-activation in TAK patients. Furthermore, the value of the IGRA assay decreased after treatment with immunosuppressive agents for TAK patients. Therefore, IGRA cannot be used to predict the risk of TB occurrence in patients with TAK, a conclusion that helps reduce unnecessary medical spending.

Written by the Department of Rheumatology and the Publicity Department

Translated by Liu Haiyan

Reviewed by Jiang Nan and Wang Yao