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● Complete blood count, serum creatinine, and liver transaminases should be determined every 3 months and more frequently while starting, resuming, or intensifying therapy. Yearly influenza vaccination is indicated in all patients, whereas pneumococcus and hepatitis vaccinations only for certain drugs in combination with additional risk factors. Yearly ophtalomologic testing is indicated for hydroxychloroquine. Inhibitors of TNF alpha, IL-6, CTLA-4, and CD20 signaling should be given with isoniazid to patients with latent tuberculosis.
● Most antirheumatic drugs cause gastrointestinal side-effects, cutaneous allergies, and predispose patients to infections due to myelosuppression. During physical examination, watch out for symptoms of mucositis, skin allergy, and - in methotrexate-treated patients - dyspnea.
● Urge the patient to report immediately in case of fever, shortness of breath, cough, and allergic reactions.
≣ Tables 4-6