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本文引用的文献

1
Glucocorticoid use, other associated factors, and the risk of tuberculosis.糖皮质激素的使用、其他相关因素与结核病风险
Arthritis Rheum. 2006 Feb 15;55(1):19-26. doi: 10.1002/art.21705.
2
Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: associations with prednisone, disease-modifying antirheumatic drugs, and anti-tumor necrosis factor therapy.类风湿关节炎的治疗与肺炎住院风险：与泼尼松、改善病情抗风湿药及抗肿瘤坏死因子治疗的关联
Arthritis Rheum. 2006 Feb;54(2):628-34. doi: 10.1002/art.21568.
3
Safety of extended treatment with anakinra in patients with rheumatoid arthritis.类风湿关节炎患者使用阿那白滞素延长治疗的安全性。
Ann Rheum Dis. 2006 Aug;65(8):1006-12. doi: 10.1136/ard.2005.048371. Epub 2006 Jan 5.
4
The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment.PREMIER研究：一项多中心、随机、双盲临床试验，对比阿达木单抗联合甲氨蝶呤与单用甲氨蝶呤或单用阿达木单抗治疗早期侵袭性类风湿关节炎且既往未接受过甲氨蝶呤治疗的患者。
Arthritis Rheum. 2006 Jan;54(1):26-37. doi: 10.1002/art.21519.
5
Baseline comorbidity levels in biologic and standard DMARD treated patients with rheumatoid arthritis: results from a national patient register.类风湿关节炎患者接受生物制剂和标准改善病情抗风湿药治疗的基线合并症水平：一项全国患者登记研究的结果
Ann Rheum Dis. 2006 Jul;65(7):895-8. doi: 10.1136/ard.2005.043158. Epub 2005 Dec 8.
6
Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis.甲氨蝶呤、肿瘤坏死因子阻滞剂及泼尼松龙对类风湿关节炎患者肺炎球菌多糖疫苗抗体应答的影响
Rheumatology (Oxford). 2006 Jan;45(1):106-11. doi: 10.1093/rheumatology/kei193. Epub 2005 Nov 15.
7
Infections in patients with rheumatoid arthritis treated with biologic agents.接受生物制剂治疗的类风湿关节炎患者的感染
Arthritis Rheum. 2005 Nov;52(11):3403-12. doi: 10.1002/art.21386.
8
Tuberculosis associated with therapy against tumor necrosis factor alpha.与肿瘤坏死因子α治疗相关的结核病
Arthritis Rheum. 2005 Oct;52(10):2968-74. doi: 10.1002/art.21382.
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BTS recommendations for assessing risk and for managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNF-alpha treatment.英国胸科学会关于评估开始抗TNF-α治疗患者的风险以及管理结核分枝杆菌感染和疾病的建议。
Thorax. 2005 Oct;60(10):800-5. doi: 10.1136/thx.2005.046797. Epub 2005 Jul 29.
10
Vaccination against influenza in rheumatoid arthritis: the effect of disease modifying drugs, including TNF alpha blockers.类风湿关节炎患者的流感疫苗接种：包括肿瘤坏死因子α阻滞剂在内的改善病情药物的影响。
Ann Rheum Dis. 2006 Feb;65(2):191-4. doi: 10.1136/ard.2005.036434. Epub 2005 Jul 13.

抗风湿治疗引发的严重感染：生物制剂的情况更糟吗？

Serious infections with antirheumatic therapy: are biologicals worse?

作者信息

Winthrop K L

机构信息

Division of Infectious Diseases, School of Medicine, Oregon Health Sciences University, 3375 SW Terwilliger Boulevard, Portland, OR 97239-4197, USA.

出版信息

Ann Rheum Dis. 2006 Nov;65 Suppl 3(Suppl 3):iii54-7. doi: 10.1136/ard.2006.058503.

DOI:10.1136/ard.2006.058503
PMID:17038474
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1798385/
Abstract

This paper reviews the current evidence for the role of antirheumatic therapy in the development of serious infections in patients with rheumatoid arthritis (RA). Prednisone is clearly associated with increased infectious risk, but no definitive data link methotrexate to infection. Emerging data suggest that biological agents also pose increase infectious risk, particularly when used in combination with corticosteroids or methotrexate. Further research is needed in this important aspect of RA treatment. In the meantime, the author recommends that physicians should remain vigilant for serious infections in their patients with RA and use appropriate vaccines and screening procedures to mitigate their risk.

摘要

本文综述了抗风湿治疗在类风湿关节炎（RA）患者发生严重感染中所起作用的当前证据。泼尼松显然与感染风险增加相关，但尚无确凿数据表明甲氨蝶呤与感染有关。新出现的数据表明，生物制剂也会增加感染风险，尤其是在与皮质类固醇或甲氨蝶呤联合使用时。在RA治疗的这一重要方面仍需进一步研究。与此同时，作者建议医生应对其RA患者的严重感染保持警惕，并使用适当的疫苗和筛查程序来降低风险。