New onset of dermatomyositis/polymyositis during anti-TNF-α therapies: a systematic literature review.
New onset of dermatomyositis/polymyositis during anti-TNF-α therapies: a systematic literature review.
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DOI：
10.1155/2014/179180
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发表时间：
2014
影响因子：
--
通讯作者：
Massone C
中科院分区：
文献类型：
--
作者：
Brunasso AM;Aberer W;Massone C
我们对1990年至2013年的数据库进行了系统检索，以确定有关接受抗tnf -α治疗的患者新发皮肌炎/多发性肌炎（DM/PM）的文章。我们检索了13篇文献，记录了20例抗tnf -α治疗后新发DM/PM的患者。17例患者为类风湿性关节炎（RA）， 1例为克罗恩病，1例为强直性脊柱炎，1例为血清阴性关节炎。在引入抗tnf -α治疗后，91%的病例检测到抗核自身抗体。6例患者检测到抗合成酶抗体，并记录其他临床表现为间质性肺疾病（ILD）。抗肿瘤坏死因子悬液（同时使用其他免疫抑制剂）后DM/PM的改善记录在94%的病例中。DM/PM和抗合成酶综合征的出现似乎与抗tnf -α药物的使用有关，特别是在治疗开始前自身抗体阳性的慢性炎性疾病（主要是RA）患者中。特别是，医生应注意抗合成酶抗体阳性和/或ILD病史的RA患者。在这些情况下，TNF-α阻断剂的使用可能引发PM/DM或抗合成酶综合征的发作，或可能加重/触发肺部疾病。
We performed a systematic search of databases from 1990 to 2013 to identify articles concerning the new onset of dermatomyositis/polymyositis (DM/PM) in patients treated with anti-TNF-α therapy. We retrieved 13 publications describing 20 patients where the new onset of DM/PM after anti-TNF-α therapy was recorded. 17 patients were affected by rheumatoid arthritis (RA), one by Crohn's disease, one by ankylosing spondilytis, and one by seronegative arthritis. In 91% of the cases antinuclear autoantibodies were detected after the introduction of anti-TNF-α therapy. In 6 patients antisynthetase antibodies were detected and other clinical findings as interstitial lung disease (ILD) were recorded. Improvement of DM/PM after anti-TNF suspension (with the concomitant use of other immunosuppressors) was recorded in 94% of cases. The emergence of DM/PM and antisynthetase syndrome seem to be associated with the use of anti-TNF-α agents, especially in patients with chronic inflammatory diseases (mainly RA) with positive autoantibodies before therapy initiation. In particular, physicians should pay attention to patients affected by RA with positive antisynthetase antibodies and/or history of ILD. In those cases, the use of the TNF-α blocking agents may trigger the onset of PM/DM or antisynthetase syndrome or may aggravate/trigger the lung disease.
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影响因子：
5.5
作者：
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通讯作者：
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