SAT0573 TUBERCULOSIS INFECTION IN MOROCCAN PATIENTS WITH RHEUMATIC DISEASES UNDER BIOLOGIC THERAPY: A MULTICENTER NATIONAL STUDY. (2nd June 2020) - Aachari, I.
Abstract : Background: Tuberculosis (TB) is a major health problem worldwide, occurring mainly in low income countries. Therefore, screening for latent TB infection (LTBI) before initiating biologic therapy is mandated by current guidelines. Objectives: The aim of this study was to evaluate the prevalence of tuberculosis infection (TB) in Moroccan patients with rheumatic diseases under biologic therapy, and to describe the demographic characteristics of these patients as well as to explore potential risk factors. Methods: This fourteen-year nationally representative multicenter study enrolled Moroccan patients with rheumatic diseases who had been treated with biologic therapy. Patient medical records were reviewed retrospectively for demographic characteristics, underlying rheumatic diseases, associated co-morbidities, and TB related data. Results: In total, 1407 eligible patients were studied; 31 cases with active TB were identified at an estimated prevalence rate of 2.3%. The mean age was 42.9±12 years and 75.8% were males. Ankylosing spondylitis (AS) accounted for 84.8% of active TB cases and the majority of cases (31/33) occurred among anti TNF-α users. A total of 8 out of 33 patients were positive at initial Latent TB infection (LTBI) screening by tuberculin skin test (TST) and/ or interferon gamma release assay (IGRA). Consumption of unpasteurized dairy products (odds ratio [OR], 34, 841; 95% CI, 3, 1-389, 7; p=0, 04), diabetes (OR, 38, 468; 95% CI, 1, 6-878, 3; p=0, 022), smoking (OR, 3, 941; 95% CI, 1-159, 9; p=0, 047) and long biologic therapy duration (OR, 1, 991; 95% CI, 1, 4-16, 3; p=0, 001) were identified as risk factors for developing active TB. Conclusion: Moroccan patients with rheumatic diseases under anti TNF- α agents are at an increased TB risk especially when risk factors are present. Strict initial screening and regular monitoring of LTBI is recommended for patients living in high TB prevalence areas. Disclosure of Interests: None declared