A 50-year-old female with rheumatoid ahritis is being considered for infliximab therapy. Which of the following tests should be performed before beginning treatment?: (A) Liver function tests, (B) PPD skin test, (C) Pulmonary function tests, (D) Visual examination
Answer is B. Infliximab is a monoclonal antibody targeting TNF-a. It is commonly used to treat moderate to severe rheumatoid ahritis paicularly in patients who do not respond to methotrexate therapy. TNF-a inhibitors can lead to reactivation of latent tuberculosis due to TNF-a inhibitor action. All patients being considered for TNF-a inhibitor therapy should therefore have a baseline PPD skin test to screen for latent tuberculosis.