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[结节病与抗TNF药物:一种矛盾的类效应?法国药物警戒系统数据库分析及文献综述]

[Sarcoïdosis and anti-TNF: a paradoxical class effect? Analysis of the French Pharmacovigilance system database and literature review].

作者信息

Javot Lucie, Tala Stéphane, Scala-Bertola Julien, Massy Nathalie, Trenque Thierry, Baldin Bernadette, Andréjak Michel, Gillet Pierre, Petitpain Nadine

机构信息

Centre Régional de Pharmacovigilance, Hôpital Central, CHU, Nancy, France.

出版信息

Therapie. 2011 Mar-Apr;66(2):149-54. doi: 10.2515/therapie/2011014. Epub 2011 Jun 6.

Abstract

OBJECTIVES

To identify and characterize the observations of sarcoidosis occurring during anti-TNF blockade collected in the French Pharmacovigilance system database and reported in the literature.

RESULTS

Seven cases were reported in the French Pharmacovigilance system database and 39 cases (37 original) have been reported internationally. Monoclonal antibodies (infliximab and adalimumab) and fusion protein (etanercept) are equally involved. Sarcoidosis have been confirmed histologically and occurred predominantly in the rheumatoid arthritis (22) and spondylarthropathy (16).

CONCLUSION

The lack of protopathic bias suggests that these paradoxical sarcoidosis occurring during treatment with anti-TNF are a class-effect, as with psoriasis, uveitis, and IBD reported under similar conditions. Their pathogenesis remains unclear.

摘要

目的

识别并描述法国药物警戒系统数据库中收集到的、并在文献中报道的抗TNF治疗期间发生的结节病观察结果。

结果

法国药物警戒系统数据库中报告了7例,国际上共报告了39例(37例为原始病例)。单克隆抗体(英夫利昔单抗和阿达木单抗)和融合蛋白(依那西普)同样涉及其中。结节病已通过组织学确诊,主要发生于类风湿关节炎(22例)和脊柱关节病(16例)患者中。

结论

缺乏原发病倾向表明,这些在抗TNF治疗期间出现的矛盾性结节病与在类似情况下报告的银屑病、葡萄膜炎和炎症性肠病一样,是一种类效应。其发病机制仍不清楚。

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