QuestionSBA
QuestionChoice
Anti-infliximab antibodies can be generated in response to therapy with the drug. Measuring these may be indicated if patients have an inadequate response to infliximab. They are not routinely measured at the start of therapy.
10028250
e
Anti-infliximab antibodies
QuestionChoice
The majority of the adult population have been infected with EBV. Serology is only useful if an acute infection is suspected. Excluding latent TB is more important.
10028247
b
Epstein Barr virus serology
QuestionChoice
Reactivation of latent TB infection is a concern with the use of biologics such as infliximab. Screening with an IGRA (e.g. the Quantiferon test) should be carried out. This is supported by NICE guidelines and the BNF.
10028246
a
Tuberculosis inteferon gamma release assay (IGRA)
QuestionChoice
Hepatitis A virus causes an acute hepatitis. If there is no suspicion of infection, testing is not appropriate. Hepatitis B virus should be tested for, however, as biologics can cause virus reactivation (due to immunosuppression).
10028248
c
Hepatitis A virus serology
QuestionChoice
While it is useful to confirm that patients receiving biologics have received all of their routine immunisations, testing for mumps immunity is not routine before starting biologics.
10028249
d
Mumps antibodies
Concept
Chapter
2693
3732
Ulcerative Colitis
Topic
136
Gastroenterology
18047
A chest X-ray is recommended before starting biologic therapy to check for active tuberculosis, as these medications suppress the immune system and can increase the risk of latent TB reactivation and severe infection.
A patient admitted with acute severe ulcerative colitis has not responded to a prolonged course of intravenous hydrocortisone. Treatment with biologics is being considered.

Which of the following investigations should be undertaken before biologics can be administered?
a