Thomas Konstantinos, Vassilopoulos Dimitrios
4 Department of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Clinical Immunology-Rheumatology Unit, 2 Department of Medicine and Laboratory, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Mediterr J Rheumatol. 2020 Jun 11;31(Suppl 1):129-136. doi: 10.31138/mjr.31.1.129. eCollection 2020 Jun.
The third decade of the 21 century marks the beginning of a new era in the treatment of rheumatoid arthritis (RA). Recently, after the introduction in clinical practice of different biologics in the first decade, three different oral synthetic targeted agents (JAK inhibitors) have been licensed for the treatment of RA, in patients who had failed or are intolerant to disease modifying anti-rheumatic drugs (DMARDs). Despite the significant progress that these agents bring to the care of RA patients, the risk of infections is still present and clear, given that their risk for serious infections is at least comparable with that of biologic DMARDs, whereas the incidence of herpes zoster is higher than that of bDMARDs. Here, we review the most recent data regarding the risk for serious and opportunistic infections in RA patients treated with biologics or JAK inhibitors, as well the up-to-date approach for managing and preventing such infections in RA patients.
21世纪的第三个十年标志着类风湿关节炎（RA）治疗新时代的开始。最近，在第一个十年不同生物制剂引入临床实践之后，三种不同的口服合成靶向药物（JAK抑制剂）已被批准用于治疗对改善病情抗风湿药（DMARDs）治疗失败或不耐受的RA患者。尽管这些药物给RA患者的治疗带来了显著进展，但感染风险仍然存在且很明显，因为它们导致严重感染的风险至少与生物DMARDs相当，而带状疱疹的发病率高于生物DMARDs。在此，我们回顾了关于使用生物制剂或JAK抑制剂治疗的RA患者发生严重和机会性感染风险的最新数据，以及在RA患者中管理和预防此类感染的最新方法。
