Inflammatory Bowel Disease Clinic, University of Calgary, Room 6D30, Teaching, Research, and Wellness (TRW) Building, 3280 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.
Nat Rev Gastroenterol Hepatol. 2010 Feb;7(2):93-101. doi: 10.1038/nrgastro.2009.221.
The introduction of biologic therapy for the treatment of IBD has substantially changed its management. The safety concerns associated with biologic therapies include the increased risk of infection, autoimmunity, development of lymphoma and demyelinating disease, and the risk of worsening heart failure. There are several strategies for minimizing the risks associated with biologic therapies. Pretreatment strategies include taking a proper history from the patient, physical examination of the patient, screening for latent tuberculosis and ruling out sepsis. Vaccination of patients against vaccine preventable diseases is also recommended. During treatment, patients should be closely monitored and any symptoms that develop should be dealt with early. Education of physicians and patients is also important to allow the early detection of any adverse events.
生物治疗的引入极大地改变了炎症性肠病的治疗方式。生物治疗相关的安全性问题包括感染风险增加、自身免疫、淋巴瘤和脱髓鞘疾病的发生风险，以及心力衰竭恶化的风险。有几种策略可以最大程度地降低生物治疗的风险。预处理策略包括从患者那里获取完整的病史、对患者进行体格检查、筛查潜伏性结核和排除脓毒症。还建议对患者进行疫苗接种，预防可通过疫苗预防的疾病。在治疗期间，应密切监测患者，及早处理出现的任何症状。对医生和患者进行教育也很重要，以便及早发现任何不良事件。
