Wijnands M J, van Riel P L
Department of Rheumatology, University Hospital Nijmegen, The Netherlands.
Drug Saf. 1995 Oct;13(4):219-27. doi: 10.2165/00002018-199513040-00002.
Therapy with disease modifying antirheumatic agents (DMARDs) is often complicated by the occurrence of adverse effects. Although risk factors for several DMARDs have been reported, the prediction of adverse drug reactions is not yet possible. Therefore regular monitoring remains mandatory. Monitoring for adverse effects to DMARDs usually includes one or more of the following: blood count, liver, kidney, urine or ophthalmologic tests. Since most adverse reactions occur during the first few months of treatment, monitoring should be more intense and frequent in this initial phase. Some adverse effects are dose-dependent, and therefore dosage reduction may help alleviate these. Others are idiosyncratic, and often necessitate drug withdrawal. Except for (hydroxy)chloroquine-induced retinopathy and methotrexate-induced liver cirrhosis, most adverse reactions to DMARDs are fortunately reversible.
使用改善病情抗风湿药（DMARDs）进行治疗时，常常会因出现不良反应而变得复杂。尽管已经报道了几种DMARDs的风险因素，但药物不良反应的预测目前仍无法做到。因此，定期监测仍然是必不可少的。对DMARDs不良反应的监测通常包括以下一项或多项：血细胞计数、肝脏、肾脏、尿液或眼科检查。由于大多数不良反应发生在治疗的最初几个月，因此在这个初始阶段监测应该更密集和频繁。一些不良反应是剂量依赖性的，因此减少剂量可能有助于缓解这些反应。其他不良反应是特异质性的，通常需要停药。幸运的是，除了（羟基）氯喹引起的视网膜病变和甲氨蝶呤引起的肝硬化外，大多数DMARDs的不良反应都是可逆的。
