Immunosuppressive therapy: Difference between revisions
From IDWiki
(→) |
(→) |
||
Line 37: | Line 37: | ||
|} |
|} |
||
− | [[Category: |
+ | [[Category:Immunocompromised patients]] |
Revision as of 17:16, 17 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 |