Serious bacterial infections in patients with rheumatoid arthritis under anti-TNF-α therapy
Serious bacterial infections in patients with rheumatoid arthritis under anti-TNF-α therapy
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DOI：
10.1093/rheumatology/keg263
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发表时间：
2003-05-01
期刊：
影响因子：
5.5
通讯作者：
Hasler, P
中科院分区：
文献类型：
--
作者：
Kroesen, S;Widmer, AF;Hasler, P
Objective.随着抗肿瘤坏死因子α（TNF-α）治疗类风湿性关节炎（RA），克罗恩病和其他疾病的数量不断增加，没有意识到潜在陷阱的医生越来越有可能遇到相关的严重感染。本研究的目的是评估抗TNF-α治疗的RA患者严重感染的发生率和性质。我们回顾了RA患者在抗TNF-α治疗前2年和治疗期间严重感染的病例和传染病科的记录。严重感染影响18.3%接受英夫利西单抗或依那西普治疗的患者。发生率为0.181/抗TNF-α治疗年，而抗TNF-α治疗前2年为0.008。在一些病例中，只有少数体征或症状表明发生感染的严重程度，包括败血症。在接受抗TNF-α治疗的患者中，需要高度怀疑感染。我们建议额外的战略，预防，快速识别和先发制人的治疗，这样的感染。
Objective. With rising numbers of anti-tumour necrosis factor alpha (TNF-alpha) treatments for rheumatoid arthritis (RA), Crohn's disease and other conditions, physicians unaware of potential pitfalls are increasingly likely to encounter associated severe infections. Our purpose was to assess the incidence and nature of severe infections in our RA patients under anti-TNF-alpha therapy.Methods. We reviewed patient charts and records of the Infectious Disease Unit for serious infections in patients with RA in the 2 yr preceding anti-TNF-alpha therapy and during therapy.Results. Serious infections affected 18.3% of patients treated with infliximab or etanercept. The incidence was 0.181 per anti-TNF-alpha treatment year vs 0.008 in the 2 yr preceding anti-TNF-alpha therapy. In several cases, only a few signs or symptoms indicated the severity of developing infections, including sepsis.Conclusions. A high level of suspicion of infection is necessary in patients under anti-TNF-alpha therapy. We suggest additional strategies for the prevention, rapid identification and pre-emptive therapy of such infections.