Czekalska Anna, Majewski Dominik, Puszczewicz Mariusz
Department of Rheumatology and Internal Medicine, Poznan University of Medical Sciences, Poland.
Reumatologia. 2019;57(4):214-220. doi: 10.5114/reum.2019.87616. Epub 2019 Aug 31.
Biological disease-modifying antirheumatic drugs target specific components of the immune response related to pathogenesis of autoimmune and inflammatory diseases. Introduction of biologic therapies has enabled better disease control than conventional drugs and thus a reduction in comorbidity and mortality. However, there is concern about adverse effects of these drugs including infections, cancers and drug-induced autoimmune diseases. Patients undergoing biologic treatment are at small but significant risk of serious infections. The overall risk of malignancies in patients on biologics compared with the general population is not increased, but there is evidence of a higher risk of individual cancers. Surprisingly, biological treatment may induce autoantibody production and, rarely, development of autoimmune diseases. A growing body of literature has evaluated the risk of adverse effects during biologic therapies. This paper outlines adverse effects of biological disease-modifying antirheumatic drugs related to immune system disorders, both immunodeficiency and autoimmunity.
生物性改善病情抗风湿药物作用于与自身免疫性疾病和炎性疾病发病机制相关的免疫反应特定成分。生物疗法的引入比传统药物能更好地控制疾病，从而降低了合并症和死亡率。然而，人们担心这些药物的不良反应，包括感染、癌症和药物诱导的自身免疫性疾病。接受生物治疗的患者发生严重感染的风险虽小但显著。与普通人群相比，接受生物制剂治疗的患者发生恶性肿瘤的总体风险并未增加，但有证据表明某些个别癌症的风险更高。令人惊讶的是，生物治疗可能会诱导自身抗体产生，且很少会引发自身免疫性疾病。越来越多的文献评估了生物治疗期间的不良反应风险。本文概述了生物性改善病情抗风湿药物与免疫系统紊乱（免疫缺陷和自身免疫）相关的不良反应。
