REVIEW - Laboratory monitoring of biologic therapies

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Clin Exp Rheumatol. 2005 Sep-Oct;23(5 Suppl 39):S90-2.

Laboratory monitoring of biologic therapies.

Cush JJ, Yazici Y.

Rheumatology and Clinical Immunology, Presbyterian Hospital of Dallas, 8200

Walnut Hill Lane, Dallas, TX 75231-4496, USA.

The purpose of this report is to provide suggested guidance concerning the

monitoring of TNF blocker therapy. Since the completion of randomized

trials, several new long-term safety concerns have arisen, involving

mycobacterial and opportunistic infections, cytopenias, lymphoma,

demyelinating disease, drug-induced lupus, congestive heart failure and

hepatotoxicity. Since these serious events are rare, widespread

post-marketing use and prolonged follow-up have been required to analyze

their prevalence. Monitoring of TNF inhibitors is necessary to reassure

physicians and patients of the continued efficacy and safety of these drugs.

No published recommendations on monitoring are available. The clinician must

weigh the potential clinical benefits of TNF inhibition against potential

adverse effects. Patients should be evaluated carefully for the risk or

presence of infection, tuberculosis and other serious adverse events by

regular visits, careful clinical assessments, and an assiduous, high index

of suspicion for these rare events. Tuberculin skin testing using PPD is

recommended before starting treatment with any TNF inhibitor.

PMID: 16273791

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6273791

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