Behrangi Elham, Moodi Farzan, Jafarzadeh Alireza, Goodarzi Azadeh
Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Skin Res Technol. 2024 May;30(5):e13718. doi: 10.1111/srt.13718.
Due to the increasing prevalence of immune-mediated diseases such as psoriasis, lichen planus, rheumatoid arthritis and inflammatory bowel disease, dermatologists have turned to new biologic drugs known as DMARDs (disease-modifying anti-rheumatic drugs) in recent years.
In this study, we evaluate the immune-mediated dermatological side effects of DMARDS by reviewing and analyzing previous peer-reviewed research on the effects of TNF-α inhibitors in the treatment of skin diseases, as well as adverse effects of these drugs and some of the main causes of these effects.
DMARDs are very effective in improving control of the above diseases. TNF-α inhibitors are an important group of DMARDs that are widely used. The paradoxical adverse events (PAEs) associated with the use of TNF-α inhibitors are divided into three categories: true paradoxical, borderline paradoxical, and non-paradoxical. True PAEs include conditions for which TNF-α inhibitors are approved for treatment. Borderline PAEs are considered to occur with this class of drugs for which there is no definite approval but for which there is sufficient evidence. Although these events are rare, early recognition of the accused drug and appropriate decision-making may prevent progression of complications and irreversible side effects.
由于银屑病、扁平苔藓、类风湿性关节炎和炎症性肠病等免疫介导疾病的患病率不断上升，近年来皮肤科医生已转向使用称为疾病改善抗风湿药物（DMARDs）的新型生物药物。
在本研究中，我们通过回顾和分析先前关于TNF-α抑制剂治疗皮肤病效果的同行评审研究，以及这些药物的不良反应和这些反应的一些主要原因，来评估DMARDs的免疫介导的皮肤副作用。
DMARDs在改善上述疾病的控制方面非常有效。TNF-α抑制剂是广泛使用的一类重要的DMARDs。与使用TNF-α抑制剂相关的矛盾不良事件（PAEs）分为三类：真正的矛盾事件、临界矛盾事件和非矛盾事件。真正的PAEs包括TNF-α抑制剂被批准用于治疗的病症。临界PAEs被认为发生在这类药物中，对此类药物尚无明确批准，但有充分证据。尽管这些事件很少见，但早期识别被指控的药物并做出适当决策可能会防止并发症的进展和不可逆的副作用。
