Immunosuppressive therapy: Difference between revisions
From IDWiki
Content deleted Content added
m Aidan moved page Special Immune Immunosuppressive therapy to Immunosuppressive therapy without leaving a redirect |
No edit summary |
||
| Line 1: | Line 1: | ||
= Immunosuppressive therapy = |
|||
== Screening == |
== Screening == |
||
| Line 38: | Line 36: | ||
| |
| |
||
|} |
|} |
||
[[Category:Immunosuppressed patients]] |
|||
Revision as of 01:30, 16 August 2019
Screening
Before starting immunosuppressive therapy, consider the following investigations:
- Tuberculin skin test
- Strongyloides serology, if from endemic country
- Hep B and C serology
- Cytomegalovirus serology
- HIV serology
Management
- Latent TB infection: start treatment at least 4 weeks prior to starting the biologic
Specific Medications
| Medications | Target | Specific Risks |
|---|---|---|
| Eculizumab | C5 complement | Meningococcus (very high risk), needs MCV4 + MenB + pen prophylaxis |
| Rituximab | CD20, on B cells | Long-term B cell depletion |
| Natalizumab | α4-integrin, on all leukocytes except neutrophils | JC virus |
| Ibrutinib | Bruton's tyrosine kinase (BTK), on B cells |
