Screening, prophylaxis and counselling before the start of biological therapies: A practical approach focused on IBD patients

• Type: Another Publication in an International Scientific Journal
• Date: 2017

Authors

Abreu, C (Author) FMUP; Sarmento A (Author) FMUP; Magro F (Author) FMUP

Journal

Title: Digestive and Liver Disease

Vol. 49

Pages: 1289-1297

ISSN: 1590-8658

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 11 Citations

Scopus - 12 Citations

Other information

Authenticus ID: P-00N-C33

DOI: 10.1016/j.did.2017.09.002

Abstract (EN): The standard of care in the management of immune-mediated inflammatory conditions relies on immunomodulators, glucocorticoids, and biologicals (including anti-tumour necrosis factor -alpha and other monoclonal antibodies). These agents have an overall favourable benefit/risk ratio; however, they modulate the immune response as part of their mechanisms of action, and therefore they may increase the risk of developing infections, particularly in older patients or in patients with concomitant corticosteroids. Some of these infections may be preventable by immunization, chemoprophylaxis or counselling. AIM: screening for and monitoring infections throughout these therapies is so mandatory to ensure patients' safety. Still, standardized guidelines focused on these procedures have yet to be established. This review aims to fill such a gap. The authors searched for articles published in English from 2009 until 2017 using PUBMED, with the terms "immunomodulators", "biological drugs", "anti-TNF alpha", "inflammatory bowel diseases", "immunomediated inflammatory diseases", "risk of infection", "infection prevention", "screening", "immunization", "tuberculosis", "latent tuberculosis", "listeriosis", "endemic mycosis", "Pneumocystis jiroveci pneumonia", "granulomatous infection", "varicella", "herpes virus", "hepatitis B", "hepatitis A", "hepatitis C" and identified the journal articles. Based on the literature and in their own experience the authors established recommendations and a practical guide for infections' screening, monitoring and prevention before and during immunomodulatory and biological therapies.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9