Rheumatism is a chronic self-immunizing disease, and the use of biological agents can significantly improve disease management and the quality of life of patients. However, as biological agents may affect the immune system and increase the risk of infection, a series of tests are required before and during the initiation of their use to ensure safety and effectiveness. The following are the tests and monitoring needs of patients in RA before and after the use of biological agents:
1. Initial assessment a. Medical history and medical examination Comprehensive medical history: Doctors will ask in detail the patient ‘ s medical history, including the duration of the symptoms, their severity, the effects of past treatment, the history of allergies, the history of infections and the history of exposure to tuberculosis (TB) or other chronic infections. Medical examination: To assess the swelling, pain, activity and other system performance of joints in order to obtain a comprehensive picture of the disease ‘ s activity. b. Laboratory testing Blood routines: examination of white cells, erythrocytes and slab counts to assess patients ‘ basic health and the presence of anaemia or infection. Hepatic and kidney function: Assessment of liver and kidney function, as certain biological agents may affect these organs. Inflammatory markers: C reaction protein (CRP) and red cell deposition (ESR) are used to assess inflammation activity. Rheumatist (RF) and Acupuncture Antibodies (ACPA): Helping to confirm the diagnosis of RA. c. Infection screening Tuberculosis screening: As biological agents inhibit the immune system, potential tuberculosis infections must be excluded prior to use. Tuberculosis fungus skin test (TST) or interferon release test (IGRA), as well as chest X-rays, are commonly performed. Hepatitis B and C screening: These viral infections may be reactivated under immunosuppressive conditions and therefore require screening prior to the use of biological agents.
2. Monitoring during the use of biological agentsa. Periodic laboratory examinations Blood routines and liver and kidney functions: periodic monitoring to ensure that drugs do not adversely affect blood cells and liver and kidney functions. Inflammatory markers: CRP and ESR are regularly measured to assess treatment effectiveness and disease activity. (b) Surveillance of infection symptoms: patients should regularly monitor the presence of infection symptoms, such as fever, cough, respiratory difficulties or other discomfort, and access to timely medical care. Tuberculosis Review: TB screening may need to be periodically reviewed among high-risk populations to ensure that there is no potential infection.
3. Other relevant examinationsa. Visual examinations X-rays, ultrasounds or MRI: used to monitor structural changes in joints and to assess treatment effects, especially when symptoms change or disease activity increases. b. Immunological function assessment Immunoglobin level: In some cases, the immunoglobin level may need to be examined to assess the immune function.
Patient education and self-monitoring
Self-monitoring: Patients should understand the potential side effects of biological agents and the risk of infection and report promptly any abnormal symptoms.
(b) Lifestyle adjustments: patients are advised to adopt a healthy lifestyle, including a reasonable diet, moderate exercise and cessation of smoking, in order to increase their immunity and improve overall health.
5. Individualized treatment programmes
Regular follow-up: patients should follow up regularly to discuss with doctors the effects of treatment and any side effects in order to adjust treatment programmes in a timely manner.
Multidisciplinary cooperation: When necessary, rheumatologists may work with other specialists, such as infectious specialists or immunologists, to ensure comprehensive disease management.
In the management of rheumatism arthritis, the use of biological agents is a powerful cure, but it needs to be carried out under strict monitoring and management. Through comprehensive initial assessments and ongoing monitoring, the treatment of drugs can be maximized while minimizing risks.
Rheumatism arthritis
