Biologic agents for psoriasis, in particular tumor necrosis factor alpha (TNF-α) inhibitors, increase the risk of latent tuberculosis (TB) reactivation, prompting routine TB screening prior to initiating these biologics.
Purpose
We sought to review the current guidelines for the screening and management of TB while using biologic agents.
Methods
A systematic search of the MEDLINE PubMed database was performed to review guidelines published from dermatology and rheumatology associations worldwide.
Results
We reviewed eight guidelines in psoriasis and rheumatoid arthritis patients regarding the screening and management of TB with TNF-α inhibitor therapy. There was consensus among all the guidelines that TB screening should be performed prior to initiating therapy. As far as annual TB screening, the current guidelines in psoriasis and rheumatoid arthritis suggest routine monitoring only in patients at risk for TB exposure.
Discussion
Dermatologists should utilize clinical judgment based on risk factors for TB exposure to determine whether to perform annual TB testing in their patients on biologics.
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