hx of severe infection tx

hx of severe infection tx

• A. TNF inhibitors
• B. IL-6 inhibitors
• C. Rituximab
• D. Abatacept

Answer: (D)

In a patient with a history of severe infections, the safety profile regarding infections guides which biologic to choose. Abatacept (a T-cell costimulation blocker) tends to have a lower risk of serious infections compared with agents that block TNF or deplete B cells. Its mechanism dampens T-cell activation without broadly impairing innate immune defenses or granuloma formation as strongly as TNF inhibitors do, and it does not cause the B-cell–depleting effects seen with rituximab. IL-6 inhibitors carry infection risk as well, but the overall infection risk in a patient with prior severe infections is typically more favorable with abatacept. Therefore, abatacept is preferred in this scenario.

In a patient with a history of severe infections, the safety profile regarding infections guides which biologic to choose. Abatacept (a T-cell costimulation blocker) tends to have a lower risk of serious infections compared with agents that block TNF or deplete B cells. Its mechanism dampens T-cell activation without broadly impairing innate immune defenses or granuloma formation as strongly as TNF inhibitors do, and it does not cause the B-cell–depleting effects seen with rituximab. IL-6 inhibitors carry infection risk as well, but the overall infection risk in a patient with prior severe infections is typically more favorable with abatacept. Therefore, abatacept is preferred in this scenario.