Abstract | BACKGROUND: OBJECTIVE: Our aim was to arrive at a consensus on the kind of monitoring and the vaccinations that should be performed before and during biologic therapy. METHODS: Medical literature and data presented at meetings were reviewed and a consensus conference was held by members of the Medical Board of the National Psoriasis Foundation. RESULTS: Consensus was established on monitoring and vaccination practices that included discussion and recognition of variations in those practices. History, physical examination, chemistry screen with liver function tests, complete blood cell count, and platelet count and tuberculosis testing are widely obtained at baseline and with variable frequencies thereafter. Patients treated with efalizumab have platelet counts checked more often; liver function tests are repeated more frequently in patients treated with infliximab; patients taking tumor necrosis factor blockers undergo tuberculosis testing more often; and patients treated with alefacept have CD4 counts checked approximately every 2 weeks. Avoidance of live vaccines during biologic therapy and administration of essential vaccines before biologic therapy were discussed, although vaccination is performed only to a variable degree. There was no consistency in the measurement of antinuclear antibodies among the experts. LIMITATIONS: CONCLUSIONS:
|
Authors | Mark Lebwohl, Jerry Bagel, Joel M Gelfand, Dafna Gladman, Kenneth B Gordon, Sylvia Hsu, Robert E Kalb, Alexa Boer Kimball, Neil J Korman, Gerald G Krueger, Philip Mease, Warwick L Morison, Amy Paller, David M Pariser, Christopher Ritchlin, Bruce Strober, Abby Van Voorhees, Gerald D Weinstein, Melodie Young, Liz Horn |
Journal | Journal of the American Academy of Dermatology
(J Am Acad Dermatol)
Vol. 58
Issue 1
Pg. 94-105
(Jan 2008)
ISSN: 1097-6787 [Electronic] United States |
PMID | 17980456
(Publication Type: Consensus Development Conference, Journal Article)
|
Chemical References |
- Antibodies, Antinuclear
- Biological Products
|
Topics |
- Antibodies, Antinuclear
(blood)
- Biological Products
(therapeutic use)
- Foundations
- Hematologic Tests
- Humans
- Liver Function Tests
- Medical Records
- Physical Examination
- Population Surveillance
(methods)
- Psoriasis
(blood, diagnosis, therapy)
- Tuberculin Test
- United States
- Vaccination
|