Author: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, February 2016.
Refer to standard texts and locally approved datasheets for detailed pharmacology and therapeutics about the immune-modulating drugs discussed here.
Second-line drugs commonly used in dermatology (on- or off-label) include:
These are prescribed by specialists, but other health professionals may be involved in the patient’s care. They should be aware at least of indications, contraindications, adverse effects and monitoring requirements.
Immune modulating drugs are used for diverse chronic inflammatory skin diseases that are not adequately controlled in other ways. The skin disease should be severe or have a severe functional or psychosocial impact on the patient.
The patient is assessed to determine:
Pregnancy and breastfeeding
Recent vaccination with a live vaccine
Drug interactions are very common with these drugs
Follow-up visits are to determine the efficacy of treatment and any adverse events and to monitor safety.
The possible adverse events from drugs are numerous. Common ones are listed here. They may require a reduction in dose or stopping treatment.
People on long-term treatment with immune modulating drugs should undergo full body examination in case of skin cancer.
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