Centrala begrepp
Pretreatment testing for patients on immunomodulators falls short of recommendations.
Sammanfattning
The content discusses the analysis of over 120,000 individuals in a national commercial insurance claims database regarding pretreatment testing for patients starting systemic immunomodulatory therapies for chronic skin diseases. The study aimed to assess the adherence to recommended screening guidelines for hepatitis B, hepatitis C, tuberculosis, and other tests before initiating treatment with immunomodulators. The findings revealed significant gaps in testing practices, highlighting the need for improvement in adherence to guidelines and the development of tailored testing practices for each agent based on patient history and clinical profile.
Key Highlights:
- Pretreatment testing for patients on immunomodulators is crucial to prevent complications.
- Recommendations for screening patients before starting immunomodulatory therapies.
- Analysis of over 120,000 individuals with chronic skin diseases.
- Variations in laboratory testing practices across different immunomodulatory agents.
- Importance of understanding reasons for variations in testing practices and their impact on patient outcomes.
- Call to action for ongoing assessment of the safety, clinical utility, and cost-effectiveness of pretreatment testing.
Statistik
"The primary outcome was the proportion of patients who underwent recommended screening lab tests including tuberculosis, hepatitis, liver function, complete blood cell counts (CBCs), and lipid panels within 6 months before treatment initiation and during the first 2 years of treatment."
"A CBC was the most common pretreatment test across treatments, performed in 41%-69% of patients before starting treatment."
"Tuberculosis screening occurred in 11%-59% of patients within 6 months of initiating treatment."
"13%-41% of patients underwent hepatitis screening prior to treatment."
Citat
"Despite recommendations from professional societies, there was a lack of clarity on how consistently these guidelines were being followed in the United States." - Maria C. Schneeweiss, MD
"The key message for clinicians is that there are considerable variations in laboratory testing practices with regard to the initiation of systemic immunomodulatory agents in patients with CISDs." - Denys Shay