Does briumvi require regular hepatic function tests?

Briumvi and Hepatic Function Test Requirements

No, Briumvi (ublituximab) does not require hepatic function tests every six months. Based on the available evidence, there are no specific recommendations for regular hepatic function monitoring for Briumvi.

General Principles of Hepatic Monitoring

• Hepatic function monitoring requirements vary by medication class and individual drug properties 1, 2
• Monitoring is typically recommended for medications with known hepatotoxicity risk profiles 3, 4
• The frequency of monitoring should be based on the medication's risk profile and patient-specific factors 1

Medications That Do Require Regular Hepatic Monitoring

• Methotrexate: Requires regular liver function tests every 3-6 months, with more intensive monitoring for patients with risk factors for hepatotoxicity 1
• Isoniazid (for TB treatment): Requires baseline and periodic monitoring, especially in patients with risk factors for liver disease 1
• Certain antivirals for hepatitis B: Require monitoring every 2-6 months depending on disease severity 1

Monitoring Recommendations for Immunomodulatory Therapies

• For patients on immunosuppressive therapies, hepatic monitoring is primarily indicated in specific situations:
  • When using medications with known hepatotoxic potential 1
  • When patients have underlying liver disease or risk factors 1
  • When screening for viral hepatitis reactivation (particularly HBV) in patients on immunosuppressive therapy 1

Hepatitis Screening Before Immunosuppressive Therapy

• Screening for hepatitis B (HBsAg, anti-HBcore, anti-HBs) is recommended before starting immunosuppressive therapies 1
• Periodic monitoring (every 3-6 months) of HBV DNA and liver function tests is recommended for patients with evidence of past or current HBV infection who are on immunosuppressive therapy 1

When to Consider Hepatic Monitoring

• Baseline liver function tests may be appropriate before starting any immunosuppressive therapy 1
• Regular monitoring is indicated for patients with:
  • Pre-existing liver disease 1
  • Concomitant use of other hepatotoxic medications 1, 3
  • Development of symptoms suggestive of hepatotoxicity 5, 3

In conclusion, while regular monitoring of liver function is important for many medications with known hepatotoxic potential, there is no specific requirement for regular hepatic function tests every six months for Briumvi based on the available evidence.