Latent Tuberculosis Screening Among New Users of a Biologic or Targeted Synthetic Disease‐Modifying Antirheumatic Drug: Gaps in Screening Overall and Among Janus Kinase Inhibitors
Authors' conclusion
We report higher screening rates than have previously been published because of combining claims and EHR data. However, important safety gaps remain, namely, reduced screening among new users of a JAKi or IL-17i and among Asian and Hispanic patients, as well as low-performing practices.
Study context
- Population
- New users of a b/tsDMARD in 2018 (no claim or prescription in the prior year) in the Rheumatology Informatics System for Effectiveness (RISE) registry and Medicare
- Outcome
- Proportion with any latent TB screening before b/tsDMARD start
- Follow-up
- 1 year before medication start
Methodological detailsclaims and electronic health record (EHR) data combined, logistic regression
- Claims and EHR data combined
- Logistic regression
Main finding
As reported in the abstract
Any tuberculosis (TB) screening within 1 year before drug start
65.6%
Observational data: associations, not effects.
Further findings
Any TB screening, 3-year window · 3 years before drug start
- Any TB screening within 3 years
- 72.9%
TB screening within 1 year by drug type · 1 year before drug start
- JAKi
- 46%
- IL-17 inhibitors
- 11.5%
- Most other drugs: greater or equal to the overall screening rate
TB screening by race/ethnicity
- Lower proportion of Hispanic and Asian patients screened vs White patients
Practice screening rates within 1 year · 1 year before drug start
- Range across practices
- 20.0% to 92.9%
Original publication
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