Health maintenance for adults with neuromuscular diseases on immunosuppression.

Immunosuppressants are commonly used in the treatment of neuromuscular diseases. The use of these medications requires health maintenance screening and monitoring for multiple potential sides effects, which may be best conducted when the prescribing physician and primary care physician work in tandem. Clinical practice guidelines, recommendations from professional organizations, prescription drug labeling, and expert opinion were reviewed and combined to provide recommendations for health maintenance for eight different immunosuppressants. Recommendations are provided for vaccinations, infection prophylaxis, laboratory monitoring, bone density screening, cancer screening, and other considerations. While studies in individuals with neuromuscular diseases are sparse, knowledge gained from the use of immunosuppressants in other conditions is applied in this review to provide recommendations to be used during the treatment of neuromuscular diseases in adults. Muscle Nerve 59:397-403, 2019.