Recommended laboratory controls at treatment initiation and follow-up
Laboratory parameters | MTX | Acitretin | Cyclosporin | Fumarates |
---|---|---|---|---|
Blood count* | X, W1, W2, W4, then every 2–3 months | X, W8, W16 | X, W2, W4, then every 4 weeks until month 4 | X, every 4 weeks until month 4, therafter every 8 weeks |
Liver enzymes** | X, W2, W4, then every 2–3 months | X, W4, W8, then every 3 months | X, W2, W4, then every 4 weeks until month 4 | X, every 4 weeks until month 4, therafter every 8 weeks |
Creatinine | X, W4, then every 2–3 months | X | X, W2, W4, then every 4 weeks until month 4 | X, every 4 weeks until month 4, therafter every 8 weeks |
Electrolytes (sodium, potassium) | - | - | X, W2, W4, then every 4 weeks until month 4 | - |
Magnesium | - | - | Only with indication (muscle cramps). X, W8, W16 | - |
Fasting blood glucose (if elevated, up HbA1c dosage) | - | X, W8 | X, then every 3 months | - |
Cholesterol, triglycerides | - | X, W4, then every 3 months | X (two weeks before and on the day of treatment initiation), W8, W16 | - |
Urine status | X, every 2 weeks during first two months, thereafter every 2–3 months | - | X, W4, W16 | X, every 4 weeks until month 4, therafter every 8 weeks |
Uric acid | - | - | X, then every 4 weeks until month 4 | - |
Albumin | X | - | - | - |
Pregnancy test | X | X. Every month during treatment and 1 and 2 months following discontinuation. Avoid pregnancy for 3 years | X | X |
HBV/HCV | X | - | X | - |
HIV | X | - | X | - |
Procollagen III peptide/Fibroscan | Every 6–12 months for PIIIP/1–2 years for Fibroscan | - | - | - |
Chest X-ray | X | - | - | - |
Liver ultrasound | X | - | - | - |
Not all tests are necessary for every patient. Patient history, exposure to risk, and patient characteristics should be considered. More specific testing may be required based on clinical signs, risk, and exposure. X: pretreatment recommended; PIIIP: procollagen type III N-terminal peptide; *: erythrocytes, leucocytes, platelets; **: alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), serum bilirubin; -: no available agent