Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 6: What Necessary Testing Should Be Performed Before Initiating Biologic Therapy? (continued)

Maria Laura Annunziata, MD, PhD; David T. Rubin, MD

The current biologic therapies for inflammatory bowel disease (IBD) include infliximab and adalimumab, which were approved in North America, Australia, and Western Europe. Certolizumab pegol was approved in the United States and Switzerland and natalizumab in the United States. Although these therapies have demonstrated efficacy for induction and maintenance of response and remission in patients with IBD, they are also associated with a 4-fold increased risk of opportunistic infection (odds ratio, 4.4; 95% confidence interval, 1.2-17.1),1 and certain testing is recommended prior…