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首页> 美国卫生研究院文献>Annals of the Rheumatic Diseases >Systematic safety follow up in a cohort of 107 patients with spondyloarthropathy treated with infliximab: a new perspective on the role of host defence in the pathogenesis of the disease?
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Systematic safety follow up in a cohort of 107 patients with spondyloarthropathy treated with infliximab: a new perspective on the role of host defence in the pathogenesis of the disease?

机译：在107例英夫利昔单抗治疗的脊椎关节炎患者中进行系统安全性随访：宿主防御在疾病发病机理中的作用的新观点？

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>Background: Recent studies with infliximab indicate the therapeutic potential of tumour necrosis factor α blockade in spondyloarthropathy (SpA). Because defective host defence is implicated in the pathogenesis of SpA, the potential side effects of this treatment due to impact on the antimicrobial defence are a major concern. >Objective: To report systematically the adverse events seen in a large cohort of patients with SpA treated with infliximab, with special attention to bacterial infections. >Patients and methods: 107 patients with SpA were treated with infliximab for a total of 191.5 patient years. All serious and/or treatment related adverse events were reported. >Results: Eight severe infections occurred, including two reactivations of tuberculosis and three retropharyngeal abscesses, and six minor infections with clear bacterial focus. One patient developed a spinocellular carcinoma of the skin. No cases of demyelinating disease or lupus-like syndrome were seen. Two patients had an infusion reaction, which, however, did not relapse during the next infusion. Finally, three patients with ankylosing spondylitis developed palmoplantar pustulosis. All patients recovered completely with adequate treatment, and infliximab treatment had to be stopped in only five patients with severe infections. >Conclusions: Although the global safety of infliximab in SpA is good compared with previous reports in rheumatoid arthritis and Crohn's disease, the occurrence of infections such as tuberculosis and retropharyngeal abscesses highlights the importance of careful screening and follow up. Focal nasopharyngeal infections and infection related symptoms, possibly induced by streptococci, occurred frequently, suggesting an impairment of specific host defence mechanisms in SpA.
机译：>背景：英夫利昔单抗的最新研究表明，肿瘤坏死因子α阻滞剂可治疗脊椎关节病（SpA）。因为有缺陷的宿主防御系统与SpA的发病机制有关，因此，由于这种方法对抗菌防御系统的影响而引起的潜在副作用是一个主要问题。 >目的：系统地报告在英夫利昔单抗治疗的SpA大批患者中观察到的不良事件，并特别注意细菌感染。 >患者和方法： 107例SpA患者接受了英夫利昔单抗治疗，总计191.5病人年。报告了所有严重和/或与治疗有关的不良事件。 >结果：发生了8例严重感染，包括两次结核病再激活和3例咽后脓肿，以及6例细菌明确的轻度感染。一名患者发生了皮肤的旋转细胞癌。未见脱髓鞘疾病或狼疮样综合征的病例。两名患者有输注反应，但是在下一次输注期间并未复发。最后，三例强直性脊柱炎患者发展了掌plant脓疱病。所有患者均经过充分治疗后完全康复，只有5名严重感染患者必须停止英夫利昔单抗治疗。 >结论：尽管与以前关于类风湿关节炎和克罗恩病的报道相比，英夫利昔单抗在SpA中的总体安全性良好，但是诸如结核和咽后脓肿等感染的发生凸显了仔细筛查和随访的重要性。可能由链球菌引起的局灶性鼻咽感染和与感染相关的症状频繁发生，表明SpA中特定的宿主防御机制受损。

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