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Survey of rheumatologists on the use of the Philippine Guidelines on the Screening for Tuberculosis prior to use of Biologic Agents
Author(s) -
AquinoVillamin Melissa,
TankehTorres Sandra,
Lichauco Juan Javier
Publication year - 2016
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12656
Subject(s) - medicine , tuberculosis , tuberculin , biologic agents , rheumatoid arthritis , incidence (geometry) , intensive care medicine , family medicine , physical therapy , pathology , physics , optics
Background The use of biologic agents has become an important option in treating patients with rheumatoid arthritis. However, these drugs have been associated with an increased risk of tuberculosis ( TB ) reactivation. Local guidelines for TB screening prior to the use of biologic agents were developed to address this issue. Aim This study is a survey describing the compliance of Filipino rheumatologists to these guidelines. Method Eighty‐seven rheumatologists in the Philippines were given the questionnaire and responses from 61 rheumatologists were included in the analysis. Results All respondents agree that patients should be screened prior to giving the biologic agents. Local guidelines recommend screening with tuberculin skin test ( TST ) and chest radiograph. However, cut‐off values considered for a positive TST and timing of initiation of biologic agents after starting TB prophylaxis and treatment varied among respondents. In addition, screening of close household contacts were only performed by 41 (69.5%) respondents. There were 11 respondents who reported 16 patients developing TB during or after receiving biologic agents, despite adherence to the guidelines. Conclusion This survey describes the compliance rate of Filipino rheumatologists in applying current local recommendations for TB screening prior to initiating biologic agents. The incidence of new TB cases despite the current guidelines emphasizes the importance of compliance and the need to revise the guidelines based on updated existing literature.