在两名患有结性脊髓炎和同时患有活跃结核病的患者中,sequinumab的治疗经验
Fatih Albayrak1, Nurcihan Y Savaş2, Melis Mutlu3
1Department of Rheumatology, Gaziantep University, Gaziantep, Turkey.
BMJ case reports
|November 12, 2025
概括
患有活跃结核病 (TB) 的性脊柱炎患者可能受益于secukinumab. 这种干白素-17A抑制剂在两种情况下证明了安全性和有效性,在瘤缩因子抑制剂禁用时提供了替代方案.
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:
- 瘤坏死因子 (TNF) 抑制剂对结椎炎 (AS) 有效,但会增加结核病 (TB) 的风险.
- 像secukinumab这样的干白素-17A (IL-17A) 抑制剂没有与结核病复激活有关,但它们在活性结核病中的安全性尚不清楚.
研究的目的:
- 评估sequukinumab在AS和活跃结核病患者中的安全性和有效性.
- 评估sequinumab作为一种替代生物疗法,当TNF抑制剂因结核病而禁用时.
主要方法:
- 两名AS患者的病例报告,他们在抗TNF治疗期间发展出活性结核病.
- 在标准的四种药物结核病疗法后2个月开始使用secokinumab.
- 监测AS疾病活动,结核病管理和不良事件.
主要成果:
- 两位患者都通过使用secukinumab.b获得了AS活性的快速和持续控制.
- 在这两位患者中,secukinumab并没有影响结核病的治疗.
- 在1年的随访期间,患者完成了9个月的抗结核治疗,没有任何不良事件或TB重新激活.
结论:
- 当TNF抑制剂禁用时,secukinumab似乎是AS患有活跃结核病的患者的安全和有效选择.
- 需要在更大的研究中进行进一步的调查来证实这些发现.
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