Table 2.

Key points in monitoring patients on biological therapies

LABORATORY TESTS
• Annual TB skin test; alternatives include the QuantiFERON®-TB gold blood test and chest x-ray if indicated
• CD4+ T-lymphocyte count every two weeks for alefacept
• Complete metabolic panel with liver function tests for each infliximab infusion and with any sign of hepatic injury
• +/− Complete metabolic panel every 3 to 6 months on all biological therapies
• +/− Complete blood count every 3 to 6 months on all biological therapies
• +/− Hepatitis screen and HIV testing when risk factors present on all biological therapies
VACCINATIONS
• +/− Influenza and pneumococcal vaccination (high-risk patients per CDC recommendations)
• +/− Standard vaccinations avoiding live and live-attenuated vaccines
• Vaccination may not be beneficial in patients taking efalizumab