Immunotherapy

Guidelines

> Steroid Alert Card - Adrenal Crisis

> Acute Immunotherapy Management Guidelines

> Subsequent Management Guidelines

Specialties contact list

Should further expert advice and investigations be indicated, we have identified specialists from within the Cheshire and Merseyside network who may be contacted for urgent advice and input:

SpecialityNameLocation Contact details

Cardiology

Dr Rebecca Dobson

Liverpool Heart and Chest

rebecca.dobson9@nhs.net

Dermatology




Dr Elaine Hindle

St Helens and Knowsley (St Helens)

Runs a weekly urgent review clinic –contactable via secretary or via referral letter.

Switchboard: 01744 266 33

Endocrinology

Dr Sid McNulty

St Helens and Knowsley (Whiston)

Happy to be contacted on his mobile through Switchboard: 0151 426 1600
Gastroenterology Dr Sree Subramanian LUHFT - Royal Happy to be contacted on his mobile through switchboard: 0151 706 2000
Hepatology Dr Imran Patanwala LUHFT - Royal Happy to be contacted on his mobile through switchboard: 0151 706 2000

Renal



Dr Noshaba Naz

WUTH
noshaba.naz1@nhs.net

Switchboard 0151 678 5111
Respiratory
Dr Lisa Spencer LUHFT - Aintree lisa.spencer@liverpoolft.nhs.uk
Rheumatology

Dr Nicola Goodson LUHFT - Aintree nicola.goodson@liverpool.ac.uk
UveitisN/ASt Pauls Eye A&E - LUHFT RoyalFor concerns regarding Uveitis please send patient to St Pauls Eye A&E at the Royal Liverpool.

Referrals

For CCC internal referrals:

Please Refer via Meditech

To refer into the IO Team for an Immunotherapy Related Toxicity – internal referrals should go through Meditech using the following pathway: Orders Panel – New Orders – Internal Referrals – Immunotherapy Toxicity.

Please do not refer via the paper referral form.

For referrals from services external to CCC:

Please refer to the service via the referral form and email to: ccf-tr.iotox-referral@nhs.net.

Resources

> Infliximab For Immune-Mediated Colitis Protocol V2.0

> Oral Methotrexate for Use in Immune Mediated Conditions Protocol V1.0

> Steroid tapering guidance V2.0

Steroid card

e-learning module

Immunotherapy alert card

FAQs

Can patients have the flu vaccine whilst on immunotherapy?

There is no evidence to suggest that the flu vaccine is associated with any issues when on immunotherapy therefore we are currently recommending that people should have their flu vaccine as normal.

*If the patient is over 65 there is a new booster to the vaccine. There is no evidence about this and possible interactions with immunotherapies so having this booster therapy is not recommended

If the pneumococcal vaccine is recommended by a patients GP practice they can also receive this.

Patient should avoid live vaccines as it is unclear whether there is an increased risk with these vaccines at present (NB the nasal flu vaccine is live)

Can I have dental treatment done whilst receiving immunotherapy?

Yes.