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银屑病生物治疗的不良反应。

Adverse reactions of biological therapy for psoriasis.

作者信息

Brănişteanu Daciana Elena, Voicu Cătălina Maria, Creţu Anca, Dimitriu Andreea, Luca Mihaela Cătălina, Sălăvăstru Carmen Maria

出版信息

Rev Med Chir Soc Med Nat Iasi. 2015 Jan-Mar;119(1):38-44.

Abstract

AIM

To detect in patients with psoriasis the adverse effects during TNF-a inhibitor therapy.

MATERIAL AND METHODS

Fifty-seven patients with psoriasis, aged between 12 and 75 years were analyzed. They were treated with different TNF-α antagonists, the maximum treatment duration being 59 months. All patients were followed monthly after the initiation of therapy by clinical checkup, then every 3 months during the first 6 months of treatment by laboratory screening, and then every 6 month. Chest x-ray and tuberculin intradermal skin test were performed annually or as needed. All symptoms reported by patients were recorded, the treating doctor deciding the need for additional investigations or specialist consult.

RESULTS

Of the total of 57 patients with psoriasis on biological therapy, 9 patients developed diseases requiring temporary or permanent discontinuation of therapy. The recorded adverse reactions were: infectious (pulmonary tuberculosis, pulmonary empyema), oncologic (rectal cancer, renal cancer), dermatologic (vesiculobullous erythema multiforme major, nodular hypodermtis, secondary erythroderma, and hives) disorders.

CONCLUSIONS

Despite its adverse reactions, biological therapy is safe and is a necessary tool in the treatment of moderate and severe forms of psoriasis unresponsive to other treatments.

摘要

目的

检测银屑病患者在肿瘤坏死因子-α(TNF-α)抑制剂治疗期间的不良反应。

材料与方法

分析了57例年龄在12至75岁之间的银屑病患者。他们接受了不同的TNF-α拮抗剂治疗,最长治疗时间为59个月。治疗开始后,所有患者每月进行临床检查随访,在治疗的前6个月每3个月进行实验室筛查,之后每6个月进行一次。每年或根据需要进行胸部X光检查和结核菌素皮内试验。记录患者报告的所有症状,由主治医生决定是否需要进一步检查或专科会诊。

结果

在接受生物治疗的57例银屑病患者中,有9例出现了需要暂时或永久停药的疾病。记录的不良反应包括:感染性疾病(肺结核、肺脓肿)、肿瘤性疾病(直肠癌、肾癌)、皮肤疾病(重症多形性水疱性红斑、结节性皮下脂膜炎、继发性红皮病和荨麻疹)。

结论

尽管存在不良反应,但生物治疗是安全的,并且是治疗对其他治疗无反应的中度和重度银屑病的必要手段。

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