Division of Pulmonary/Critical Care Medicine.
Clin Infect Dis. 2014 Jun;58(11):1587-98. doi: 10.1093/cid/ciu104. Epub 2014 Feb 27.
Patients with rheumatoid arthritis and other immune-mediated inflammatory diseases are at higher risk for infectious morbidity and mortality, partially due to the therapies used to treat these conditions. Both prednisone and targeted biologic therapies such as tumor necrosis factor antagonists have been implicated to various degrees, although in some cases firm data are lacking with regard to certain types of infections. To date, there is a paucity of information regarding the infectious risks associated with the newer biologic agents. As new biologic agents become available for use, their potential infectious risks will challenge infectious disease clinicians who must work to prevent, diagnose, and treat infections in this setting. This article reviews our current understanding of infectious risk in the setting of targeted therapies and provides an update of the immune system targets and potential infectious sequelae of both current and emerging biologic therapies.
患有类风湿关节炎和其他免疫介导的炎症性疾病的患者发生感染性发病率和死亡率的风险较高，这部分是由于用于治疗这些疾病的治疗方法。泼尼松和肿瘤坏死因子拮抗剂等靶向生物疗法都在不同程度上受到牵连，尽管在某些情况下，某些类型的感染缺乏确凿的数据。迄今为止，有关新型生物制剂相关感染风险的信息很少。随着新型生物制剂的出现，它们潜在的感染风险将对传染病临床医生构成挑战，他们必须努力预防、诊断和治疗这种情况下的感染。本文综述了我们目前对靶向治疗中感染风险的认识，并更新了当前和新兴生物治疗的免疫系统靶点和潜在感染后果。
