Leis-Dosil V M, Prats-Caelles I
Sección de Dermatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
Sección de Dermatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
Actas Dermosifiliogr (Engl Ed). 2018 Jan-Feb;109(1):24-34. doi: 10.1016/j.ad.2017.05.005. Epub 2017 Sep 28.
The treatment of inflammatory and autoimmune diseases is challenging because of their frequency and complexity. Treatment of these diseases is based on the suppression of the patient's immune system using corticosteroids, corticosteroid-sparing immunosuppressive agents, and biologic drugs, making an understanding of the management of immunosuppressive therapy essential. Before an immunosuppressive agent is prescribed, a study must be carried out to identify contraindications, detect latent infections, and determine the most appropriate dose. During treatment, regular monitoring is required to detect adverse effects. The clinician must be familiar with the time lag between start of treatment and onset of the immunosuppressive effect as well as the maximum recommended duration of treatment and cumulative dose for each drug. As dermatologists we are accustomed to using these immunosuppressive agents, but we should have a good knowledge of the guidelines for their use and the monitoring required in each case if we are to reduce variability and avoid potentially serious adverse effects.
炎症性和自身免疫性疾病的治疗颇具挑战性，这是由于其发病频率和复杂性所致。这些疾病的治疗基于使用皮质类固醇、皮质类固醇节省型免疫抑制剂和生物药物来抑制患者的免疫系统，因此了解免疫抑制治疗的管理至关重要。在开免疫抑制剂处方之前，必须进行一项研究，以确定禁忌症、检测潜伏感染并确定最合适的剂量。在治疗期间，需要定期监测以检测不良反应。临床医生必须熟悉治疗开始与免疫抑制效果出现之间的时间间隔，以及每种药物的最大推荐治疗持续时间和累积剂量。作为皮肤科医生，我们习惯于使用这些免疫抑制剂，但如果我们要减少变异性并避免潜在的严重不良反应，就应该充分了解其使用指南以及每种情况下所需的监测。
