Institute of Clinical Pharmacology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Inflammopharmacology. 2017 Dec;25(6):665-671. doi: 10.1007/s10787-017-0365-9. Epub 2017 May 31.
Intravenous (IV) infusion of aminobisphosphonates (ABP) induces cytokine release by peripheral blood Vγ9δ2 T cells, resulting in an immediate short-term inflammatory response in up to 50% of patients. We evaluated possible long-term pro-inflammatory effects of IV ABP.
Retrospective case-series study from one rheumatology specialist's clinic. 2261 electronic charts were reviewed for administration of 'zoledronate' or different brand names of zoledronic acid, and relevant clinical data was retrieved for patients who had received the infusion.
Thirteen patients had recieved zoledronate. In six, new-onset or exacerbation of a previous inflammatory/autoimmune disorder was diagnosed within 3 months following infusion. Of these, one patient developed new-onset rheumatoid arthritis (RA), two polymyalgia rheumatica (PMR), two suffered a flare of Crohn's disease-related and aromatase inhibitor-induced arthralgias, and one patient acquired autoimmune hemophilia. Pre-existing malignancy and immediate inflammatory response following zoledronate were more frequent in patients experiencing new or worsening immunologic manifestations (3/6 vs. 0/7, and 5/6 vs. 2/7, respectively).
Intravenous ABP may trigger induction of persistent autoimmune syndromes, especially when accompanied by an immediate adverse reaction or pre-existing malignancy.
静脉注射（IV）氨基双膦酸盐（ABP）可引起外周血 Vγ9δ2 T 细胞释放细胞因子，导致多达 50%的患者出现即刻短期炎症反应。我们评估了 IV ABP 可能产生的长期促炎作用。
一项来自一家风湿病专家诊所的回顾性病例系列研究。对“唑来膦酸”或不同品牌唑来膦酸的“zoledronate”的 2261 份电子病历进行了审查，并为接受过该输注的患者检索了相关临床数据。
13 名患者接受了唑来膦酸治疗。其中 6 名患者在输注后 3 个月内诊断出新发或原有炎症/自身免疫性疾病加重。其中，1 例新发类风湿关节炎（RA），2 例多发性肌炎（PMR），2 例克罗恩病相关和芳香化酶抑制剂诱导的关节痛加重，1 例获得自身免疫性血友病。在出现新的或加重的免疫表现的患者中，预先存在的恶性肿瘤和唑来膦酸输注后的即刻炎症反应更为常见（3/6 与 0/7，5/6 与 2/7）。
静脉注射 ABP 可能引发持续性自身免疫综合征，尤其是伴有即刻不良反应或预先存在的恶性肿瘤时。
