Final answer:
Before initiating TNF inhibitor therapy in Rheumatoid Arthritis patients, screening for tuberculosis and hepatitis B and C is essential. Additionally, testing for other autoimmune diseases using the ANA test can provide further insights into a patient's health status.
Step-by-step explanation:
Before beginning treatment with TNF inhibitors (TNF-i) for Rheumatoid Arthritis (RA) patients, it is important to test for certain infections due to the immunosuppressive nature of these drugs. Patients should be screened for tuberculosis (TB) with a skin test or interferon-gamma release assay. It is also recommended to test for hepatitis B and C, as reactivation of these viruses can occur during immunosuppressive therapy. Furthermore, although not necessarily a pre-treatment requirement, screening for lupus and other autoimmune diseases, using tests such as the antinuclear antibody (ANA) test, may also provide valuable information, given that RA is also an autoimmune disorder.
RA is a chronic, inflammatory joint disease with activation of CD4 T cells and chronic release of inflammatory cytokines such as IL-1, IL-6, and TNF-α, which result in symptoms and damage that can be visualized through diagnostic imaging such as X-rays, MRI, and arthrography, and via blood tests for RF, anti-CCP, CRP, and ESR.