Bratcher Jason M, Korelitz Burton I
Lenox Hill Hospital and NYU School of Medicine, Department of Gastroenterology, 100 East 77th Street, New York, NY 10021-1882, USA.
Expert Opin Drug Saf. 2006 Jan;5(1):9-16. doi: 10.1517/14740338.5.1.9.
Infliximab is a monoclonal antibody directed against the pro-inflammatory mediator TNF-alpha, which was approved in the US in 1998 for treatment-resistant Crohn's disease. Since that time, the indications have dramatically expanded to include rheumatoid arthritis, ankylosing spondylitis, psoriasis and most recently, active ulcerative colitis. Although the safety profile in the initial studies was quite favourable, subsequent studies have shown that a small percentage of patients reported severe side effects, including pneumonia, tuberculosis, lymphoma, drug-induced lupus and hepatotoxicity. Although these complications are rare, it is important to properly screen patients for predisposing conditions before beginning treatment. Furthermore, concurrent use of other immunosuppresive agents, such as 6-mercaptopurine, may reduce the incidence of less serious side effects, such as arthralgias, myopathies and other antibody-associated diseases. Since its approval, infliximab has revolutionised the treatment of Crohn's disease and has shown benefit in a variety of other inflammatory conditions, but significant toxicities can occur that necessitate thorough screening protocols and periodic clinical evaluation.
英夫利昔单抗是一种针对促炎介质肿瘤坏死因子-α的单克隆抗体，于1998年在美国被批准用于治疗抵抗性克罗恩病。从那时起，其适应证已大幅扩展，包括类风湿性关节炎、强直性脊柱炎、银屑病，以及最近的活动性溃疡性结肠炎。尽管初始研究中的安全性相当良好，但后续研究表明，一小部分患者报告了严重的副作用，包括肺炎、肺结核、淋巴瘤、药物性狼疮和肝毒性。尽管这些并发症很罕见，但在开始治疗前对患者进行易患疾病的适当筛查很重要。此外，同时使用其他免疫抑制剂，如6-巯基嘌呤，可能会降低不太严重的副作用的发生率，如关节痛、肌病和其他抗体相关疾病。自获批以来，英夫利昔单抗彻底改变了克罗恩病的治疗方法，并在多种其他炎症性疾病中显示出疗效，但可能会出现显著的毒性，这就需要全面的筛查方案和定期的临床评估。
