title: Practical use of biologic therapy in dermatology: some considerations and checklists.
abstract: BACKGROUND
  Practice varies with respect to biologic therapy counseling and monitoring of biologic therapy. Because of the complexity, many physicians shy away from prescribing biologic therapy.
  
  
  OBJECTIVE
  To create checklists and discuss considerations behind various counseling and monitoring issues.
  
  
  METHODS
  The full prescribing information of infliximab, etanercept, adalimumab, golimumab, certolizumab, alefacept, ustekinumab, rituximab, and IVIg were reviewed in addition to National Psoriasis Foundation guidelines to create the checklists.
  
  
  RESULTS
  Considerations of counseling for biologics includes explaining benefits, relative risks of not treating or alternative therapies, consequence of risk, preventability of risk, and likelihood of risk. Considerations regarding vaccination, viral hepatitis screening, tuberculosis screening, skin cancer screening, pregnancy, and anti-nuclear antibody screening are discussed.
  
  
  CONCLUSIONS
  Consensus is unavailable as to the extent of counseling or monitoring. This manuscript provides one perspective.
  
  
  CONCLUSIONS
  This article reviews monitoring and patient counseling considerations for the use of biologics in dermatology. Tables for each drug are provided with checklists for counseling and monitoring.
authors.affiliation: University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Ortleb
authors.forename: Jacob Oren
authors.initials: JO
authors.lastname: Levitt
mesh_terms: D001691:Biological Therapy / Q000009:adverse effects*; D037001:Directive Counseling; D005260:Female; D006801:Humans; D011247:Pregnancy; D012306:Risk; D012871:Skin Diseases / Q000628:therapy*; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D014409:Tumor Necrosis Factor-alpha