What question did this study set out to answer?

To evaluate the necessity of chest X-rays in tuberculosis screening before initiating biologic therapy.

February 28, 2026

Tuberculosis Screening Before Biologic Therapy: Considering Epidemiology

Key Points

To evaluate the necessity of chest X-rays in tuberculosis screening before initiating biologic therapy.
Retrospective evaluation of a dermatology cohort.
Comparison of IGRA-based screening with chest X-ray findings.
Assessment of tuberculosis incidence in the studied population.
IGRA-based screening may be sufficient in low TB incidence groups.
Routine CXR adds limited diagnostic value in the examined population.

Abstract

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.

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