Refer a Patient

Baseline Immunization Protocols for Biologic Therapy

Remicade, Inflectra, Entyvio, Stelara, Skyrizi, and Tysabri

1. TB testing prior to first treatment:

a. Quantiferon Gold: Negative (if indeterminate then repeat test, if still indeterminate then send for PPD, if patient continues with indeterminate results it is up to MD discretion regarding patients epidemiological risk)

b. CXR PA/Lat: Negative for latent TB

c. If patient positive for active TB: Biologic therapy is contraindicated

d. If patient has latent TB (positive quant gold or PPD but negative cxr): Physician to decide further course of treatment prior to biologic therapy

2. Hepatitis testing prior to first treatment:

a. Hepatitis B surface antigen
b. Hepatitis B surface antibody
c. Hepatitis B core antibody (total)

If any are positive, consult with physician prior to starting biologic therapy

3. All biological patients to be seen by prescribing physician every 6 months

4. All biologic patients to have routine lab monitoring including CBC w/o diff and hepatic function panel every 8 weeks, additional labs at discretion of the MD.