To test or not to test? An updated evidence-based assessment of the value of screening and monitoring tests when using systemic biologic agents to treat psoriasis and psoriatic arthritis - 17/08/15
Abstract |
Background |
Safety profiles of systemic biologic agents for the treatment of psoriasis and psoriatic arthritis (PsA) encompass a wide spectrum of adverse events. To date, no uniform evidence-based guidelines exist regarding screening and monitoring patients who are undergoing biologic therapy.
Objective |
We sought to identify studies evaluating screening and monitoring tests in the treatment of psoriasis and PsA with systemic biologic agents, and to propose evidence-based practical guidelines.
Methods |
The MEDLINE database was searched to identify data on risks associated with adalimumab, etanercept, infliximab, and ustekinumab. Articles were reviewed and graded according to methods developed by the US Preventative Services Task Force.
Results |
Evidence was strongest (grade B) for tuberculosis screening. Interferon-gamma release assay was preferable to tuberculin skin testing. Among known hepatitis B virus carriers, the evidence grade was C for monitoring liver function tests and viral load.
Limitations |
This study was limited by the lack of high-quality controlled trials evaluating screening and monitoring tests in patients treated with biologic agents.
Conclusions |
Baseline tuberculosis testing remains the only screening test with strong evidence to support its practice. Other screening and monitoring tests commonly performed in patients who are taking biologic agents are supported only in certain clinical settings or lack evidence to support or recommend against their practice.
Le texte complet de cet article est disponible en PDF.Key words : adalimumab, biologics, etanercept, infliximab, monitoring, psoriasis, psoriatic arthritis, safety, screening, ustekinumab
Abbreviations used : AAD, ALP, ALT, ANA, AST, BAD, BMP, CBC, CHF, CMP, CRP, DB, dsDNA, EADV, FDA, HBcAb, HBV, HCV, HBsAb, HBsAg, HIV, IGRA, JDA, LFT, NMSC, PsA, TB, TNF, TST, USPSTF
Plan
| The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, LP. Dr Feldman is a consultant and speaker for Galderma, Stiefel/GlaxoSmithKline, Abbott Labs, Warner Chilcott, Janssen, Amgen, Photomedex, Genentech, BiogenIdec, and Bristol Myers Squibb, has received grants from Galderma, Astellas, Abbott Labs, Warner Chilcott, Janssen, Amgen, Photomedex, Genentech, Biogen Idec, Coria/Valeant, Pharmaderm, Ortho Pharmaceuticals, Aventis Pharmaceuticals, LaRoche Dermatology, 3M, Bristol-Myers Squibb, Stiefel/GlaxoSmithKline, Novartis, Medicis, Leo, HanAll Pharmaceuticals, Celgene, Basilea, and Anacor, and has received stock options from Photomedex. Dr Feldman is the founder and holds stock in Causa Research. Drs Huang and Ahn, Ms Dothard, and Mr Garner have no conflicts of interest to declare. |
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| Funding sources: None. |
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| Reprints not available from the authors. |
Vol 73 - N° 3
P. 420 - septembre 2015 Retour au numéro
Article précédent
- Five-year analysis from the ESPRIT 10-year postmarketing surveillance registry of adalimumab treatment for moderate to severe psoriasis
- Alan Menter, Diamant Thaçi, Kim A. Papp, Jashin J. Wu, Mareike Bereswill, Henrique D. Teixeira, Simone Rubant, David A. Williams
- Increased risk of arrhythmia in patients with psoriatic disease: A nationwide population-based matched cohort study
- Hsien-Yi Chiu, Wei-Lun Chang, Weng-Foung Huang, Yu-Wen Wen, Yi-Wen Tsai, Tsen-Fang Tsai
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