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Latent TB before biologic therapy — SCE Respiratory MCQ

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HardTB and NTMLatent TB before biologic therapySCE Respiratory

A 59-year-old man on haemodialysis has a positive IGRA during screening before biologic therapy. CXR is normal and he has no TB symptoms. He takes warfarin for atrial fibrillation. What is the most appropriate management?

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Correct answer: C — Specialist latent TB treatment plan considering drug interactions

Latent TB treatment should be considered before biologic therapy, but regimen choice needs specialist review because rifamycins interact substantially with warfarin and other drugs. A positive IGRA in this risk context should not be dismissed. Four-drug treatment is for active TB, and BCG is not treatment.

Reference: NICE NG33 Tuberculosis; BNF