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International Journal of Rheumatology
Volume 2017, Article ID 9614241, 15 pages
Review Article

Review of Routine Laboratory Monitoring for Patients with Rheumatoid Arthritis Receiving Biologic or Nonbiologic DMARDs

1Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
2Ultragenyx Pharmaceutical, Inc., Novato, CA, USA
3Genentech, Inc., South San Francisco, CA, USA
4Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
5University of Washington, Seattle, WA, USA
6University of Florence, Florence, Italy

Correspondence should be addressed to William F. C. Rigby; ude.htuomtrad@ybgir.mailliw

Received 16 February 2017; Accepted 15 August 2017; Published 31 October 2017

Academic Editor: Ruben Burgos-Vargas

Copyright © 2017 William F. C. Rigby et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Safety concerns associated with many drugs indicated for the treatment of rheumatoid arthritis (RA) can be attenuated by the early identification of toxicity through routine laboratory monitoring; however, a comprehensive review of the recommended monitoring guidelines for the different available RA therapies is currently unavailable. The aim of this review is to summarize the current guidelines for laboratory monitoring in patients with RA and to provide an overview of the laboratory abnormality profiles associated with each drug indicated for RA. Recommendations for the frequency of laboratory monitoring of serum lipids, liver transaminases, serum creatinine, neutrophil counts, and platelet counts in patients with RA were compiled from a literature search for published recommendations and guidelines as well as the prescribing information for each drug. Laboratory abnormality profiles for each drug were compiled from the prescribing information for each drug and a literature search including meta-analyses and primary clinical trials data.