Table 2.

Checklist for patient screening for immunomodulators and/or anti-TNF-α agents

General considerations	Checkpoint
Contraindications to anti-TNF-α agents	Grade 3, 4 heart failure
	Previous lymphoma or current malignancy history
	Demyelinating disease
	History of recurrent infection
Precautions and screening	Tuberculosis: tuberculin skin test, chest x ray, interferon gamma release assay
	HBV: HBsAg, anti-HBc, anti-HBs
	HCV: anti-HCV
	HIV: antigen/antibody HIV-1/2 immunoassy
	VZV: IgM/IgG anti-VZV
Vaccination status	Live vaccination (MMR, herpes zoster, BCG, varicella): contraindicated
	Inactive vaccination (COVID-19, DTP, HAV, HPV, influenza, pneumococcus): safe

TNF-α, tumor necrosis factor-α; HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; anti-HBc, anti-hepatitis B core antibody; anti-HBs, anti-hepatitis B surface antibody; HCV, hepatitis C virus; HIV, human immunodeficiency virus; VZV, varicella zoster virus; IgM, immunoglobulin M; MMR, measles, mumps and rubella; BCG, Bacillus Calmette–Guérin; COVID-19, coronavirus disease 2019; DTP, Diphtheria-Tetanus-Pertussis; HAV, hepatitis A; HPV, human papillomavirus.