What would prompt you to obtain IGRA in a patient starting an IL-17 inhibitor for psoriasis who is also on concomitant immunosuppression despite the ‘no routine testing’ recommendations before initiating this class of biologic?

If the IGRA was indicated for the concomitant immunosuppressive drug, that would prompt me to obtain the IGRA. Also, more commonly, if the insurer required the IGRA, I would order it.

I would also get it if the patient wanted it. For most patients, I just ask if they are having cough, fever, night sweats, or unexplained weight loss.