Table 1.

Recommended baseline and routine testing for disease modifying agents

Disease Modifying Agent	Baseline testing	Routine monitoring
Interferon-beta or pegylated interferon	CBC LFT	CBC and LFT at month 1, 3, 6 then every 6 to 12 months Thyroid function tests
Glatiramer acetate	None	None
Mitoxantrone	CBC LFT EKG Echocardiogram or MUGA	CBC, LFT, and uric acid levels prior to each infusion Echocardiogram or MUGA prior to each infusion Annual echocardiogram or MUGA post discontinuation
Natalizumab	LFT JCV Ab	LFT at month 3 and 6 then every 6 months JCV Ab every 6 months Natalizumab Ab at 6 months
Fingolimod	CBC LFT VZV IgG EKG Eye exam or OCT PFT if respiratory symptoms Consider skin exam	LFT at month 3 and 6 then every 6 months Eye exam or OCT at month 3 PFT if respiratory symptoms Consider Skin exam
Teriflunomide	CBC LFT Bilirubin PPD or QFT-G	LFT monthly for 6 months then every 6 months CBC every 6 months
Dimethyl fumarate	CBC	CBC every 6 months (every 3 months if lymphocytes <750 or every month if <500) JCV Ab if lymphocytes <500
Alemtuzumab	CBC Cr UA (with cells), TSH, Skin exam	CBC, Cr, UA (with cells) monthly TSH every 3 month Skin exam annually

Ab = antibodies; CBC = complete blood count; Cr = creatinine; EKG = electrocardiogram; IgG = immunoglogulin G;; JCV = John Cunningham virus; LFT = liver function test; MUGA = multigated acquisition scan OCT = ocular coherence tomography; PFT = pulmonary function test; PPD = purified protein derivative; QFT-G = QuantiFERON ^® gold test; TSH = thyroid stimulating hormone UA = urinalysis; VZV = varicella zoster virus.