Background: Latent tuberculosis infection (LTBI) represents a significant challenge in patients with rheumatic diseases treated with disease-modifying antirheumatic drugs (DMARDs), particularly biological agents such as TNF-α inhibitors, due to an elevated risk of progression to active tuberculosis. Understanding the prevalence of LTBI and identifying associated factors is crucial for improving screening protocols and preventive strategies in this high-risk population.

Objectives: Primary Objective: Determine the prevalence of LTBI in Mexican patients with rheumatic diseases treated with DMARDs, biological agents, or small molecules. Secondary Objective: Identify factors associated with LTBI, including sociodemographic, clinical, and geographic characteristics.

Methods: This retrospective, descriptive, cross-sectional study analyzed the prevalence of LTBI in 1,453 patients with rheumatic diseases from the BIOBADAMEX database (June 2016–October 2024). Patients included all ages with confirmed diagnoses of rheumatoid arthritis, spondylarthritis, systemic lupus erythematosus, and other rheumatic conditions. Screening for LTBI was performed using tuberculin skin tests (PPD), booster tests, and interferon-gamma release assays (IGRA). Sociodemographic, clinical, and laboratory data were collected and analyzed using descriptive statistics, odds ratios (OR), and 95% confidence intervals (CI).

Results: Among the 1,453 patients analyzed, 80.4% were female, with a median age of 39.0 years. Most patients resided in northern (46.5%) and central (44.9%) Mexico, with fewer from the south (8.6%). The most frequent rheumatic diagnosis was rheumatoid arthritis (59.4%), followed by ankylosing spondylitis (12.3%) and psoriatic arthritis or other spondylarthritis (8.8%). Screening for LTBI was performed in 81.0% of patients, identifying a prevalence of 10.1%. Patients with LTBI had slightly higher, though not statistically significant, proportions of exposure to anti-TNF drugs (57.1%), other biological agents (27.7%), and anti-CD20 treatments (22.7%). BCG vaccination was associated with a protective effect against LTBI (OR 0.61, 95% CI 0.38–0.98). Interestingly, hypercholesterolemia showed a negative association with LTBI (OR 0.25, 95% CI 0.08–0.81). No significant associations were identified with the type of drug used or other comorbidities.

Conclusion: This study reveals a notable prevalence of LTBI in patients with rheumatic diseases treated with biological agents or small molecules in Mexico. Factors such as male sex, geographic region, and BCG vaccination were associated with LTBI. These findings emphasize the importance of systematic LTBI screening and tailored preventive measures to reduce the risk of progression to active tuberculosis, ultimately improving clinical outcomes and quality of life in this vulnerable population.

REFERENCES: [1] Prevalence of latent tuberculosis before biotherapy initiation in rheumatoid arthritis and spondyloarthritis: data from the Moroccan biotherapy registry Lamia. Oulkadi1 · Samira. Rostom.

[2] Prevalence trends of latent tuberculosis infection at the global, regional, and country levels from 1990–2019Cheng Ding, Ming Hu, Wanru Guo, Wenjuan Hu, Xiaomeng Li, Shuting Wang.

[3] Zavala Del Ángel A, Morales-Romero J, Zenteno-Cuevas R, et al. (May 30, 2023) Prevalence of Latent Tuberculosis Infection (LTBI) in Mexican Patients With Rheumatoid Arthritis (RA). Cureus 15(5): e39743.

Acknowledgements: To every member of BIOBADAMEX.

Disclosure of Interests: Ana Gonzalez Andrade: None declared, Luis Francisco Valdés Corona GSK, JANSSEN, ABBVIE, Vijaya Rivera Terán: None declared, David Vega-Morales: None declared, Jose Jiram Torres Ruiz: None declared, Iris J. Colunga-Pedraza: None declared, Sandra Sicsik: None declared, Angel Castillo Ortiz: None declared, Miguel A. Saavedra Salinas: None declared, Guillermo Guaracha-Basáñez: None declared, Dafhne Guadalupe Miranda Hernández: None declared, Fedra Irazoque-Palazuelos: None declared, Sandra Carrilo: None declared, Julio Cesar Casasola: None declared, Omar Eloy Muñoz-Monroy: None declared, Javier Merayo-Chalico: None declared, Estefanía Torres Valdéz: None declared, Sergio Duran Barragan: None declared, Erick Adrian Zamora-Tehozol: None declared, Daniel Xavier Xibille Friedmann: None declared, Samara Mendieta: None declared, Azucena Ramos: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.