Meyer-Olson D, Hoeper K, Schmidt R E
Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, Hannover, Germany.
Z Rheumatol. 2010 Dec;69(10):879-88. doi: 10.1007/s00393-010-0677-2.
The introduction of biological disease-modifying drugs (DMARDs) has substantially improved the treatment options for patients with rheumatoid arthritis. However, infectious complications represent the most common side effects of these drugs, including severe infections as well as rare opportunistic infections. Treating patients on biological DMARDs is therefore one of the biggest challenges in rheumatology care. The present review describes the current state of knowledge regarding frequency and type of infectious complications associated with biological DMARDs. The article focuses mainly on risk management, in particular on diagnosis and recurrence prevention of tuberculosis and reactivation of hepatitis B virus infection. Furthermore, we discuss the importance of vaccinations in primary disease prevention in patients with rheumatoid arthritis.
生物病情改善抗风湿药物(DMARDs)的引入显著改善了类风湿关节炎患者的治疗选择。然而,感染性并发症是这些药物最常见的副作用,包括严重感染以及罕见的机会性感染。因此,治疗使用生物DMARDs的患者是风湿病护理中最大的挑战之一。本综述描述了与生物DMARDs相关的感染性并发症的频率和类型的当前知识状态。本文主要关注风险管理,特别是结核病的诊断和复发预防以及乙型肝炎病毒感染的再激活。此外,我们讨论了疫苗接种在类风湿关节炎患者原发性疾病预防中的重要性。