SAT0467 CROSS-SECTIONAL SCREENING STUDY FOR MYCOBACTERIUM LEPRAE DNA AND ANTIBODIES IN PATIENTS UNDER IMMUNOBIOLOGICAL TREATMENT
Authors: Patricia Kurizky, Ciro Gomes, Mariana Cesetti, Gladys Martins, Cleandro Albuquerque, Talita Yokoy, Licia Mota
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Leprosy is an endemic disease, highly dependent of the involved proinflammatory response. Immunobiological drugs improved the treatment for autoimmune diseases, but it larger use also brought the need for screening infectious diseases. There are some case reports about leprosy and immunobiological drugs, although the real risk of leprosy in those patients is unknown. <h3>Objectives:</h3> To access the risk of leprosy by clinical and complementary evaluation in immunobiological treated patients living in endemic region. <h3>Methods:</h3> We conducted a cross-sectional screening study and consecutively included patients with autoimmune diseases attending Dermatology and Rheumatology ambulatory. Patients were tested for serology (anti-PGL1) and conventional polymerase chain reaction (PCR) targeting <i>Mycobacterium leprae</i> DNA. <h3>Results:</h3> 311 patients were included: 96 on immunobiological drugs, 94 on conventional immunosuppressive drug (mostly metothrexate), 69 on non-immunosuppressive treatment, and 52 controls with no autoimmune disease or immunosuppressive treatment. Two patients of immunobiological group were diagnosed with multibacillary leprosy. The PCR for <i>M. leprae</i> was positive in more 5 subjects (1 control, 1 on MTX and 3 on immunobiologicals). The anti-PGL1 test was performed in 284 patients, and was positive in 64, 15 with a high index (above 2). <h3>Conclusion:</h3> Immunological status is critical for leprosy control and the findings of possible subclinical infection with <i>M. leprae</i> suggest that leprosy screening should be considered in patients treated with immunosuppressive drugs. <h3>References</h3> [1] FRADE MAC, et al. Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test. PLoS neglected tropical diseases, v. 11, n.2, p.e0005375, 23 fev. 2017. [2] ANTONIO JR, et al. Biological agents: investigation into leprosy and other infectious disease before indication. An Bras Dermatol2013; 88:23-5 [3] LLUCH P, et al. Development of leprosy in a patient with rheumatoid arthritis during treatment with etanercept: a case report. Semin Arthritis Rheum201242:127-30 <h3>Disclosure of Interests:</h3> Patricia Kurizky: None declared, Ciro Gomes: None declared, Mariana Cesetti: None declared, Gladys Martins Consultant for: Jansenn, Abbvie, Novartis, Pfizer, Paid instructor for: Jansenn, Abbvie, Novartis, Pfizer, Speakers bureau: Jansenn, Abbvie, Novartis, Pfizer, Cleandro Albuquerque Shareholder of: Has received personal fees and/or non-financial support from Pfizer, AbbVie, AstraZeneca, Janssen, Bristol-Myers Squibb, Roche, Novartis and UCB, Grant/research support from: Has received personal fees and/or non-financial support from Pfizer, AbbVie, AstraZeneca, Janssen, Bristol-Myers Squibb, Roche, Novartis and UCB, Consultant for: Has received personal fees and/or non-financial support from Pfizer, AbbVie, AstraZeneca, Janssen, Bristol-Myers Squibb, Roche, Novartis and UCB, Paid instructor for: Has received personal fees and/or non-financial support from Pfizer, AbbVie, AstraZeneca, Janssen, Bristol-Myers Squibb, Roche, Novartis and UCB, Speakers bureau: Has received personal fees and/or non-financial support from Pfizer, AbbVie, AstraZeneca, Janssen, Bristol-Myers Squibb, Roche, Novartis and UCB, Talita Yokoy: None declared, Licia Mota Speakers bureau: Has delivered speeches at events sponsored by AbbVie, Janssen, Pfizer, Roche and UCB.