Incidence of Tuberculosis in Patients With Autoimmune Rheumatic Diseases

This is a prospective, randomized, controlled study designed to evaluate the effectiveness of annual re-screening for tuberculosis infection (TBI) (previous) in patients with autoimmune rheumatic diseases (ARDs) receiving biologic and/or immunosuppressive therapy. Patients with negative baseline TBI screening will be randomized to undergo annual re-screening using interferon-gamma release assay (IGRA) or to a control group without routine re-screening. Patients with newly detected TBI will receive preventive treatment. The primary objective is to assess whether annual re-screening combined with TBI treatment reduces the incidence of active tuberculosis. Secondary objectives include determining TBI conversion rates and identifying risk factors for infection.

Inclusion Criteria: * Patients (adults and children) diagnosed with autoimmune rheumatic diseases according to established international classification criteria * negative baseline screening for tuberculosis infection. Exclusion Criteria: * History of tuberculosis infection or disease * Radiographic evidence suggestive of prior TB * Previous treatment for TBD or TBI * Positive baseline TB screening; * Follow-up shorter than 12 months