25th February 2025

Monitoring of biologics

In general, monitoring requirements are:

• At baseline: FBC, U&Es, LFTs, CRP, ESR, lipids, HIV, hepatitis B and C, urinalysis (for protein), blood pressure and CXR with QuantiFERON for TB
• Patients should be treated if found to have latent TB
• FBC, U&Es and LFTs at 3-4 months, then every 6 months
• Lipid profile at 1-2 months
• Rituximab may also need Igs and CD19 monitoring 6 monthly 
• Further infection screens, if clinically indicated 

Patients should be offered vaccinations before starting treatment: influenza, pneumococcal and covid. Live vaccinations should be avoided. Education should be given about skin cancer prevention and infection risk.

There are guidelines for use in pregnancy and breastfeeding, but little data.