Heterogeneity in biologic therapy monitoring across medical specialties: a real-world study and call for standardized multidisciplinary protocols

Background: Biologic therapies require strict pre-treatment screening and monitoring due to infectious and immune-related risks. However, real-world implementation of guidelines remains heterogeneous across specialties.
Aim: To evaluate biologic therapy monitoring practices across gastroenterology, dermatology, and rheumatology, and to assess inter-specialty variability and need for harmonization.
Methods: A cross-sectional survey was conducted among physicians prescribing biologic therapies at a tertiary university hospital. Data included infectious screening, vaccination practices, monitoring strategies, and institutional protocol availability. Comparative analyses were performed between specialties.
Results: Among 137 physicians, complete pre-treatment assessment was reported by 56%. Influenza and pneumococcal vaccination rates were low (20% and 15%). Only 36% reported institutional protocols. Significant inter-specialty differences were observed, with gastroenterologists showing higher adherence to guidelines (p<0.05).
Conclusion: Marked heterogeneity exists in biologic therapy monitoring practices. Standardized multidisciplinary protocols are needed to improve adherence to recommendations and patient safety.