Tuberculosis Screening Before Biologic Therapy: Considering Epidemiology

We read with interest the retrospective evaluation by Tan et al., titled “Are chest X-rays still necessary for prebiologic tuberculosis screening? A retrospective audit” recently published in Clinical and Experimental Dermatology.¹ The authors report that IGRA-based screening may be sufficient in a dermatology cohort and that the additional diagnostic contribution of routine CXR remains limited. However, as the study was conducted in a population with a low incidence of TB, the generalizability of the findings to different epidemiological contexts warrants careful consideration.