Abstract Background/Aims Established guidelines recommend routinely screening for hepatitis B, C, HIV and TB infection prior to the initiation of advanced therapies (biologic and JAK inhibitors) in rheumatic disease. There is no guidance on the frequency or necessity to re-screen for infections prior to a switch in advanced therapy. Unnecessary rescreening has significant cost implications and can delay dispensing. Previous departmental audit of 100 consecutive patients undergoing therapy switch did not identify any new infections and cost £5,930. In 2023, a local guideline incorporating a traffic light system was developed to assist clinician decision making regarding rescreening. Methods 100 consecutive rheumatology patients who had switched advanced therapy between July and November 2024 were identified through local virtual biologic prescribing clinic lists. Retrospective review of individual electronic health records was undertaken to ascertain whether appropriate rescreening was undertaken, whether new infections were identified and establish the cost of rescreening in this cohort. Results The decision to rescreen was not impacted by the nature of rheumatic disease nor drug class. In total, 49/100 patients underwent rescreening, 51/100 patients didn’t have rescreening performed (deemed to be the appropriate decision as per the traffic light system in 86% of cases). 45/100 patients were in the ‘amber’ group for rescreening; 25/45 underwent appropriate rescreening, 17/45 were not judged to not have been rescreened appropriately. 3/45 patients could have been offered screening. Clinician choice accounted for reasons to not rescreen and no adverse clinical outcomes were noted in this group. No new infections were identified. The total pathology cost of rescreening was £517.95 (compared with £5,930 prior to the introduction of the traffic light system). Conclusion A simple, user-friendly and evidence-based traffic light system can safely assist clinicians exercise judgement in determining which patients require re-screening for communicable infection prior to therapy switch. It significantly reduces costs and provides an opportunity for allied specialties using advanced therapies to make savings locally. Disclosure E. Tranah: None. A. Ganesh Kumar: None. M. Crooks: None. Y. Xiang: None. S. Mercer: None. A. Masood: None. B. Menon: None. S. Subesinghe: None.
Tranah et al. (Wed,) studied this question.