Official Japanese guidelines for the use of infliximab for rheumatoid arthritis
Official Japanese guidelines for the use of infliximab for rheumatoid arthritis
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日本关于使用英夫利昔单抗治疗类风湿性关节炎的官方指南
DOI：
10.3109/s10165-004-0357-7
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发表时间：
2005
影响因子：
2.2
通讯作者：
K. Eguchi
中科院分区：
文献类型：
--
作者：
N. Miyasaka;T. Takeuchi;K. Eguchi
种族背景以及医疗和社会经济地位的差异往往会影响药物的疗效和不良反应。最近的数据显示，在接受英夫利昔单抗（一种嵌合单克隆抗肿瘤坏死因子α (TNF-α)抗体）治疗的类风湿关节炎（RA）患者中，机会性感染的风险增加，尤其是结核病（TB）。在这方面，日本每年的结核病发病率大约是美国的五倍。此外，由于在儿童时期，当纯化蛋白衍生物（PPD）皮肤试验呈阴性时，必须接种卡介苗-谷氨酰胺芽孢杆菌，因此在日本人口中观察到PPD皮肤试验假阳性的发生率很高。此外，在日本，甲氨蝶呤用于RA的剂量上限较低。因此，我们已经建立了英夫利昔单抗在日本RA患者中正确使用的官方指南。在这篇综述中，以证据为基础的形式提出了一种诊断和管理RA中结核病的算法。
Differences in ethnic backgrounds as well as in medical and socioeconomic status often affect both the efficacy and adverse effects of medications. Recent data suggest an increased risk of opportunistic infections, especially tuberculosis (TB), among rheumatoid arthritis (RA) patients receiving infliximab, a chimeric monoclonal anti-tumor necrosis factor α (TNF-α) antibody. In this regard, the annual incidence of TB is approximately five times higher in Japan than in the United States. Furthermore, since Bacillus Calmette-Guérin vaccination is mandatory in childhood when the skin test for purified protein derivative (PPD) is negative, a high incidence of false-positive PPD skin tests is observed among the Japanese population. In addition, the upper limit of methotrexate dosage to be used for RA is lower in Japan. We have therefore established official guidelines for the proper use of infliximab in Japanese RA patients. In this review, an algorithm for the diagnosis and management of TB in RA is presented in an evidenced-based form.