Chaparro María
Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Madrid, España; Instituto de Investigación Sanitaria Princesa (IP) y Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
Gastroenterol Hepatol. 2014 Sep;37 Suppl 3:22-30. doi: 10.1016/S0210-5705(14)70080-9.
The objective of this article is to summarize reports presented at Digestive Disease Week 2014 that relate to fertility and pregnancy, inflammatory bowel disease in elderly patients, the risk of cancer and its relationship to treatment and finally, developments regarding psychological aspects that may affect patients with inflammatory bowel disease. Studies were selected at the discretion of the author, mainly considering those with conclusions that can be applied immediately to clinical practice. Using anti-TNF drugs during pregnancy is safe in the short term. This currently seems to be true for the medium and the long term. To limit fetal exposure, the mother can safely stop taking the anti-TNF drugs in the second trimester of the pregnancy if she is in remission. Elderly patients with inflammatory bowel disease require stricter monitoring than younger patients due to the risk of complications, especially infections associated with the disease and treatments. The effect of inflammatory bowel disease and the drugs for its treatment on the risk of development is still not well established, but the magnitude of the effect seems possibly lower than previously described. The causal link between psychological factors and the occurrence of IBD relapse is by no means established.
本文的目的是总结在2014年消化疾病周上发表的与生育和妊娠、老年患者的炎症性肠病、癌症风险及其与治疗的关系，以及最后可能影响炎症性肠病患者的心理方面进展相关的报告。研究由作者自行挑选，主要考虑那些结论可立即应用于临床实践的研究。孕期短期使用抗TNF药物是安全的。目前看来，中长期使用似乎也是如此。为限制胎儿接触药物，如果母亲病情缓解，在妊娠中期可安全停用抗TNF药物。由于存在并发症风险，尤其是与疾病及治疗相关的感染风险，老年炎症性肠病患者比年轻患者需要更严格的监测。炎症性肠病及其治疗药物对癌症发生风险的影响仍未明确，但影响程度似乎可能低于先前描述。心理因素与炎症性肠病复发之间的因果关系尚未确立。
