Yazısız Veli, Yılmaz Vural Taner, Uçar İsmail, Dandin Özgür, Aslan Bengisu, Erbasan Funda, Koçak Hüseyin, Ender Terzioğlu Mustafa
Department of Internal Medicine, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey.
Department of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey.
Arch Rheumatol. 2021 Jan 14;36(3):366-374. doi: 10.46497/ArchRheumatol.2021.8500. eCollection 2021 Sep.
The aim of this study was to investigate the efficacy and safety of anti-interleukin-1 (anti-IL-1) agents and tumor necrosis factor-alpha (TNF-α) inhibitors in renal transplant patients.
Between February 2014 and February 2020, data of 12 renal transplant recipients (9 males, 3 females; median age: 51 years; range, 19 to 70 years) who received anti-IL-1 agents or TNF-α inhibitors for inflammatory diseases in the post-transplant time period and were followed in a single transplant center (n=12) were retrospectively analyzed. A total of 46 cases were reported in the literature, before the data were collected. The overall outcomes of all cases were analyzed in this study.
Thirty-seven patients received anti-IL-1 agents in the post-transplant period. The main indications for anti-IL-1 agents were familial Mediterranean fever (FMF) and amyloidosis (75.7%). The continuation rate of colchicine treatment in patients with FMF was 85.7%. Anti-IL-1 agents prevented attacks completely in 89.3% of FMF patients. The number of cases used TNF-α inhibitors among renal transplant patients was lower (n=21). The TNF-α inhibitors were used mainly for inflammatory bowel diseases (57.1%) and ankylosing spondylitis (33.3%) and suppressed the disease activity in most of the patients with inflammatory diseases (72.7%). Death (n=3) and malignancies (n=3) were reported in patients who received TNF-α inhibitors, but not in patients who received anti-IL-1. The renal outcomes and graft survival rates were satisfactory in patients who received both anti-IL-1 agents and TNF-α inhibitors.
Our results support that anti-IL-1 agents can be used effectively and safely in renal transplant patients.
本研究旨在调查抗白细胞介素-1（抗IL-1）药物和肿瘤坏死因子-α（TNF-α）抑制剂在肾移植患者中的疗效和安全性。
回顾性分析2014年2月至2020年2月期间在单个移植中心接受随访的12例肾移植受者（9例男性，3例女性；中位年龄：51岁；范围19至70岁）的数据，这些患者在移植后接受了抗IL-1药物或TNF-α抑制剂治疗炎症性疾病。在收集数据之前，文献中共报道了46例病例。本研究分析了所有病例的总体结果。
37例患者在移植后接受了抗IL-1药物治疗。抗IL-1药物的主要适应证为家族性地中海热（FMF）和淀粉样变性（75.7%）。FMF患者秋水仙碱治疗的持续率为85.7%。抗IL-1药物在89.3%的FMF患者中完全预防了发作。肾移植患者中使用TNF-α抑制剂的病例数较少（n = 21）。TNF-α抑制剂主要用于炎症性肠病（57.1%）和强直性脊柱炎（33.3%），并在大多数炎症性疾病患者中抑制了疾病活动（72.7%）。接受TNF-α抑制剂治疗的患者中有死亡病例（n = 3）和恶性肿瘤病例（n = 3），而接受抗IL-1治疗的患者中未出现此类情况。接受抗IL-1药物和TNF-α抑制剂治疗的患者的肾脏结局和移植物存活率均令人满意。
我们的结果支持抗IL-1药物可在肾移植患者中有效且安全地使用。
