A Clinician’s Perspective

Using the T-SPOT®.TB Test to Screen Rheumatology Patients for TB

Dr. Robert Jenkins is a board-certified rheumatologist and one of 11 physicians in practice at Rheumatology Associates, located in Dallas, Texas. Of the 120 patients he generally sees in a week, 10 are typically referred for tuberculosis screening.  A year ago, he started using the T-SPOT.TB test to screen his patients before starting them on TNF blockers. He describes his experience using the T-SPOT.TB test:

“I started looking into an alternative to the TST because after reading TST results for over 30 years, I know they are hard to interpret. I think the diameter of the induration is not nearly as definitive as we all pretend. So, I was happy to have a different technology. As I learned about the T-SPOT.TB test, I was impressed by how convenient it was, and that convenience, in my mind, has improved patient care in my practice.

“Collecting the testing sample is very straightforward.  We draw blood right in our office, ship it overnight to the Oxford Diagnostic Laboratory in packaging they provide, and then receive the results in 36 to 48 hours via fax. With the TST, many patients would not return to have their results read, so my staff was spending a lot of time reminding patients and trying to track them down to read their results. If patients did return to have their results read, many times they were coming  without  an  appointment,  so  the  nurses were  being  interrupted  throughout  the day to read the results, and the doctors  had to make time to talk with patients who returned with a positive TST. The system was just a pain. Now the staff really appreciates that it only takes one visit for patients to get tested—it’s just like every other blood test.

“I like that the T-SPOT.TB test results are objective, rather  than  the  subjective  results  we  got  with the  TST.  I  get  a  numerical  result,  as  well  as  a positive, borderline, or negative reading from the T-SPOT.TB test. With the TST, studies have shown that the results vary based on who reads the results, so I never had much confidence in the results, especially if I wasn’t there to see the reaction myself. Knowing the results with the T-SPOT.TB test are objective gives me a confidence boost—I just think it’s a better test.

“And because the test is so much more convenient, we are testing patients more frequently, so we’re going to find more of these people who have latent tuberculosis or have acquired it, and hopefully catch them before anything happens. On average, I test patients on biologics therapy every 2 to 3 years, and test more frequently if they travel to areas where tuberculosis is more common. We didn’t do this frequency of testing with the TST because it was too inconvenient. We typically tested them at the start of therapy and often didn’t do it again, which concerned me.

“Overall, I am really happy with my experience using the  T-SPOT.TB test over the past year.  My staff appreciates the convenience, I have more confidence in the results, and it has enhanced our overall patient care.”

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