生物药物和结核病预防疗法
Aloke G Ghoshal1, Arup Halder2
1Director, National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India.
The Journal of the Association of Physicians of India
|March 15, 2025
概括
生物制剂和JAK抑制剂增加结核病的风险. 在开始这些疗法之前查和治疗潜结核病,可以显著降低结核病发病率,尽管它不能消除它.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 生物药物已经改变了全身炎症疾病的治疗方法.
- 增加感染易感性是生物制剂的主要副作用.
- 抗TNF药物和其他生物药物,以及JAK抑制剂,增加了结核病 (TB) 重新激活的风险.
研究的目的:
- 审查与生物药物和JAK抑制剂相关的结核病再激活风险.
- 讨论当前的指导方针以及针对结核病查和治疗的量身定制方法的需要.
- 强调将结核病风险管理纳入免疫抑制疗法患者的临床实践的重要性.
主要方法:
- 对生物制剂,JAK抑制剂和结核病再激活研究的文献综述.
- 对现有的结核病查和预防的国家和国际指南进行分析.
- 讨论印度国家结核病消除计划 (NTEP) 关于结核病预防治疗 (PMTPT) 计划管理的指导方针.
主要成果:
- 生物药物,特别是抗TNF药物和JAK抑制剂与患有潜在结核病感染 (LTBI) 患者的结核病再激活的显著风险有关.
- 在开始这些疗法之前,积极的LTBI查和治疗大大降低了结核病发病率.
- 由于社会经济因素和结核病流行性,现有的指导方针在全球范围内有所不同,需要根据特定环境进行应用.
结论:
- 实施LTBI查和治疗对于在接受生物药物或JAK抑制剂的患者中减轻结核病风险至关重要.
- 虽然有效,但目前的策略并不能完全消除结核病复激活风险.
- 临床医生必须了解各种生物药物的不同结核病风险,并相应地调整查方案.
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