Safety of biological therapy – Guidelines of the Czech Society for Rheumatology


Authors: J. Vencovský;  Výbor České Revmatologické Společnosti *
Authors‘ workplace: Revmatologický ústav, Praha
Published in: Čes. Revmatol., 17, 2009, No. 3, p. 146-160.
Category: Recommendations for Treatment

Overview

In 2007, Czech Society for Rheumatology published the indications for initiation of biological therapy within the guidelines on the treatment of rheumatoid arthritis. This report follows the indication criteria, and provides an overview on safety aspects of biological therapy - most of all, the conditions for its commencement, monitoring of adverse events, and listing the reasons for its discontinuation. Particular attention is given to aspects of possible infections and malignant diseases. The issue of the detection of latent tuberculosis is discussed, and the suggestions for its detection and monitoring with up-to-date tests are given. Other situations are discussed as well, such as necessary diagnostics of hepatitis, administration of biological therapy during pregnancy and lactation, approach to biological therapy in the context of surgical intervention, and the issue of vaccination. Cardiovascular aspects are briefly mentioned as well. The necessity of long-term monitoring of all patients treated with biological therapy in a standardised way within a registry is emphasized.

Key words:
rheumatoid arthritis, anti-TNF therapy, rituximab, abatacept, tocilizumab, tuberculosis, infections, tumours


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