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英夫利昔单抗治疗克罗恩病的肺部不良反应综述

Review of pulmonary adverse effects of infliximab therapy in Crohn's disease.

作者信息

Patel Dhiren, Madani Shailender, Patel Shraddha, Guglani Lokesh

机构信息

a Pediatric Gastroenterology, The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Wayne State University School of Medicine , Detroit , MI , USA.

b Department of Emergency Medicine , Wayne State University , Detroit , MI , USA.

出版信息

Expert Opin Drug Saf. 2016 Jun;15(6):769-75. doi: 10.1517/14740338.2016.1160053. Epub 2016 Mar 16.

Abstract

INTRODUCTION

Anti-inflammatory therapies are the mainstay for the treatment of inflammatory bowel disease (IBD) in children and adults, including biologics such as infliximab. While there is extensive literature on the general side effects of therapy with infliximab, the data on pulmonary adverse effects remains sparse. This article summarizes the literature related to pulmonary adverse effects of Infliximab therapy in Crohn's Disease.

AREA COVERED

Published reports of specific pulmonary complications during ongoing therapy with infliximab in patients with IBD were included in the review. A wide variety of infectious and non-infectious complications have been reported with the use of infliximab therapy in IBD.

EXPERT OPINION

It is important to carefully evaluate respiratory signs and symptoms in patients with IBD, especially those receiving biologic therapies. Besides infectious complications, other non-infectious pulmonary adverse effects associated with the use of infliximab should be considered in patients with IBD. Further, it is important to differentiate primary pulmonary involvement of IBD from pulmonary adverse effects of infliximab therapy. An algorithm for assessing patients with IBD presenting with pulmonary symptoms is provided as a guide for clinicians for medical decision-making.

摘要

引言

抗炎疗法是儿童和成人炎症性肠病(IBD)治疗的主要手段,包括英夫利昔单抗等生物制剂。虽然关于英夫利昔单抗治疗的一般副作用有大量文献,但关于肺部不良反应的数据仍然稀少。本文总结了与英夫利昔单抗治疗克罗恩病肺部不良反应相关的文献。

涵盖领域

本综述纳入了关于IBD患者在接受英夫利昔单抗持续治疗期间特定肺部并发症的已发表报告。使用英夫利昔单抗治疗IBD已报告了多种感染性和非感染性并发症。

专家意见

仔细评估IBD患者,尤其是接受生物治疗的患者的呼吸体征和症状很重要。除了感染性并发症外,IBD患者还应考虑与使用英夫利昔单抗相关的其他非感染性肺部不良反应。此外,区分IBD的原发性肺部受累与英夫利昔单抗治疗的肺部不良反应很重要。提供了一种评估出现肺部症状的IBD患者的算法,作为临床医生进行医疗决策的指南。

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