牛皮关节炎中的感染:与治疗的关联
Athanasios Vassilopoulos1, Konstantinos Thomas2, Dimitrios Vassilopoulos3
1Division of Internal Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Therapeutic advances in musculoskeletal disease
|October 21, 2024
概括
在牛皮关节炎 (PsA) 治疗中,严重的感染是令人担忧的. 虽然一些药物是安全的,但其他药物如Janus激酶抑制剂 (JAKi) 需要仔细监测感染,如疹.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 严重感染 (SIs) 是牛皮关节炎 (PsA) 的重要并发症.
- 各种疾病修饰性抗风湿药物 (DMARDs) 用于PsA,每个药物都具有独特的感染安全概况.
- 了解这些风险对于有效管理PSA患者至关重要.
研究的目的:
- 审查和总结与PsA治疗中使用的不同药物类别相关的传染性并发症.
- 提供传统合成DMARDs,生物药物和针对性合成剂在PsA患者的安全性概述.
- 为临床医生强调特定的感染风险和安全考虑.
主要方法:
- 关于PsA治疗中的传染性并发症的现有文献的叙事综述.
- 基于药物类别的感染风险分类:传统的合成DMARD,TNF抑制剂 (TNFi),IL-12/23抑制剂 (IL-12/23i),IL-17抑制剂 (IL-17i),IL-23抑制剂 (IL-23i) 和Janus激酶抑制剂 (JAKi).
- 综合关于每种治疗方式相关的感染发生率和类型的证据.
主要成果:
- 传统的合成DMARDs,如甲基 (MTX) 显示了令人放心的安全性.
- 使用TNFi与潜在感染 (如结核病,乙型肝炎) 的风险增加有关,可通过查和预防来控制.
- 虽然IL-12/23i和IL-17i没有显著的安全信号,但IL-17i可能会增加轻度的Candida感染. IL-23i似乎不会增加感染风险. JAKi与阳疹有关.
结论:
- 治疗PsA涉及一系列药物,具有不同的感染风险.
- 虽然大多数治疗方法都具有可控的安全性,但由于疹病毒的风险,JAK抑制剂需要特别注意.
- 适当的患者查和监测对于安全有效的PsA管理至关重要.
相关概念视频
01:23Skin Diseases and Disorders
3.6K
Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
3.6K
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
4.1K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
4.1K
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
1
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
1
01:29Endocarditis IV: Nursing Management
2
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
2
01:20Infection
7.7K
When a pathogen enters the body and reproduces, it can cause an infection, damage body cells, and cause illness symptoms that eventually lead to disease. Therefore, its prevention requires breaking the chain of infection.
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
7.7K
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
1
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
1