From the Guidelines
A patient undergoing treatment with Humira (adalimumab) should not rely solely on a Mantoux test for tuberculosis screening due to the potential for false-negative results caused by immunosuppression. The British Association of Dermatologists' guidelines for biologic interventions for psoriasis 2009 suggest that tuberculin testing is not valid in patients already established on immunosuppressive therapy, such as those taking Humira 1. This is because Humira, as a TNF inhibitor, can suppress immune responses, potentially leading to inaccurate test results.
When considering tuberculosis screening for patients on Humira, it's crucial to weigh the limitations of the Mantoux test. Key points to consider include:
- The potential for false-negative results due to immunosuppression
- The recommendation for alternative screening methods, such as Interferon-Gamma Release Assay (IGRA) blood tests, for patients on immunosuppressive therapy
- The importance of assessing the risk of tuberculosis reactivation in patients with latent infections who are starting or are already on Humira
Given these considerations, healthcare providers should opt for IGRA tests, such as QuantiFERON-TB Gold or T-SPOT.TB, for tuberculosis screening in patients undergoing treatment with Humira, as these tests may be less affected by immunosuppressive medications 1. It is also essential for patients to inform their healthcare providers about their Humira treatment so that test results can be interpreted appropriately, and regular TB monitoring can be conducted to mitigate the risk of reactivation.
From the Research
Humira Treatment and Mantoux Test
- There is no direct evidence in the provided studies that addresses the interaction between Humira (adalimumab) treatment and the Mantoux test.
- The studies primarily focus on the interpretation, accuracy, and application of the Mantoux test in diagnosing tuberculosis, as well as comparisons with interferon-γ release assays 2, 3, 4, 5.
- One study discusses the issue of defaulters in Mantoux testing in a rural population, highlighting the importance of patient counseling to reduce dropout rates 6.
- None of the studies mention the specific context of patients undergoing treatment with Humira (adalimumab) and their eligibility to receive a Mantoux test.
- Therefore, based on the provided evidence, there are no research papers to assist in answering this question regarding the compatibility of Humira treatment with the Mantoux test 2, 3, 4, 5, 6.