A Clinician’s Perspective

Rheumatology Case Studies

Biologic-targeted suppression of key inflammatory pathways for the treatment of patients with rheumatoid arthritis (RA) has been beneficial to managing this condition. Management, however, must be balanced with the patient’s risk of infection from other diseases, such as tuberculosis (TB).1

Reactivating TB continues to be a serious concern for RA patients. RA patients are at an increased risk of developing TB while on tumor necrosis factor (TNF) antagonist therapy1 because TNF plays a key role in keeping Mycobacterium tuberculosis (MTB) in granulomas and  sufficiently suppressing  the  MTB  to  maintain  the  latent  tuberculosis  infection (LTBI)  state.  Thus,  identifying  patients  with  LTBI  and prophylactically  treating  them before starting anti-TNFα treatment is critical to reducing the patient’s risk for TB while being immunosuppressed.2

Improving Rheumatology Patient Care Using the T-SPOT®.TB  Test
Solomon Forouzesh, MD, FACD, FACR
Medical Director
Arthritis Care & Treatment Center

Clinical Associate Professor of Internal Medicine / Rheumatology
University of California Los Angeles
Cedars‐Sinai Medical Center
Los Angeles, California


Using the T-SPOT®.TB  Test to Screen Rheumatology Patients for TB
Robert Jenkins, MD, PhD
Rheumatology Associates

Clinical Assistant Professor of Internal Medicine
Division of Rheumatic Diseases
University of Texas Southwestern Medical Center
Dallas, Texas