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在儿科类风湿病中使用生物药物的不良反应
Merve Cansu Polat1, Saniye Mertek2, Zeynep Birsin Özçakar3
1Department of Pediatric Rheumatology, University of Health Sciences, Ankara City Hospital, Cankaya, Turkey.
Postgraduate medicine
|February 28, 2024
概括
治疗风湿性疾病的生物药物 (BAs) 的儿科患者经历了不良事件,包括长时间使用后增加潜在结核病 (TB) 风险. 医生应对结核病和皮肤反应进行监测,特别是使用抗IL1疗法.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 免疫学 免疫学 免疫学
- 药物监督 药物监督 药物监督
背景情况:
- 生物制剂 (BA) 越来越多地用于儿科类风湿性疾病.
- 了解这种人群中BA的安全性概况对于最佳的患者护理至关重要.
研究的目的:
- 为了评估儿科患者的不良事件 (AEs) 类风湿性疾病治疗的经批准或非标签的生物药物.
- 确定与不同类别的BAs相关的特定风险.
主要方法:
- 观察性,回顾性,多中心研究 (2010-2022年).
- 包括儿童患者 (年龄<18岁) 接受互白素-1抗体 (抗IL1),互白素-6抗体 (抗IL6) 或瘤坏死因子α抑制剂 (抗TNF).
- 从电子医疗记录中收集有关疗效,副作用和副作用发生时间的数据.
主要成果:
- 在接受315个BA治疗的237名患者中,有44名患者 (18.6%) 发生了50次副作用.
- 潜在的结核病 (TB) 和疹感染与抗TNF治疗有关.
- 反复出现的上呼吸道感染和局部皮肤反应更常见于抗IL1.
- 长达23.5个月的BA使用增加了潜结核病的风险5.94倍.
- 报告了严重的皮肤反应,如DRESS和过敏反应.
结论:
- 医生应该保持警潜伏结核病在患者在BA超过两年.
- 局部皮肤反应在抗IL1时更常见,但像DRESS这样的严重反应也可能发生.
- 在研究队列中没有观察到恶性瘤或死亡.
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