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Asthma-SMART Implementation — SCE Respiratory MCQ

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HardRespiratory MedicineAsthma-SMART ImplementationSCE Respiratory

A patient due to start anti-TNF therapy has a positive interferon-gamma release assay, normal chest radiograph and no symptoms. What is the management principle?

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Correct answer: D — Treat latent tuberculosis before anti-TNF therapy

Anti-TNF treatment carries high risk of TB reactivation. Active disease must first be excluded, then an appropriate latent-TB regimen started with timing coordinated between TB and specialty teams. Drug interactions and hepatotoxicity require review.

Reference: NICE NG33: Tuberculosis. https://www.nice.org.uk/guidance/ng33/chapter/recommendations