Öz
İnflamatuvar romatolojik hastalıklarda biyolojik ajanların kullanımı ile ilgili veri sayısı artmaktadır. Son zamanlarda, biyolojik ajanlarla ilişkili non-enfeksiyöz komplikasyonlar arasında en sık granülomatöz hastalık ve interstisyel akciğer hastalığı görülmektedir. Ek olarak, bu ilaçlarla ilişkili en ciddi yan etkiler bakteriyel pnömoni gibi solunum sistemi enfeksiyonları, tüberküloz ve Pneumocystis jirovecii pnömonisidir. Özellikle, tümör nekroz faktör-alfa (TNF-α) gibi biyolojik ajanlar ile yapılan tedaviler artmış tüberküloz riski ile ilişkilidir. Bu ilaçları alan hastalarda tüberküloz taraması ve latent tüberküloz tedavisi yapılması bu nedenle endikedir
Anahtar Kelimeler
Kaynakça
- Nakajima A, Saito K, Kojima T, et al. No increased mortality in patients with rheumatoid arthritis treated with biologics: results from the biologics register of six rheumatology institutes in Japan. Mod Rheumatol 2013 Sep;23(5):945-52. doi: 10.1007/s10165-012-0773-z.
- Greenberg JD, Reed G, Kremer JM, et al; CORRONA Investigators. Association of methotrexate and tumour necrosis factor antagonists with risk of infectious outcomes including opportunistic infections in the CORRONA registry. Ann Rheum Dis 2010 Feb;69(2):380-6.
- Takayanagi N. Biological agents and respiratory infections: Causative mechanisms and practice management. Respir Investig 2015 Sep;53(5):185-200.
- Lanternier F, Tubach F, Ravaud P, et al; Research Axed on Tolerance of Biotherapies Group. Incidence and risk factors of Legionella pneumophila pneumonia during anti-tumor necrosis factor therapy: a prospective French study. Chest 2013 Sep;144(3):990-8.
- Vallabhaneni S, Chiller TM. Fungal infections and new biologic therapies. Curr Rheumatol Rep 2016 May;18(5):29. doi: 10.1007/s11926-016-0572-1.
- Kılıç E, Kılıç G, Akgül Ö, Akgöl G, Özgöçmen S. The Reported Adverse Effects Related to Biological Agents Used for the Treatment of Rheumatic Diseases in Turkey. Turk J Rheumatol 2013;28(3):149-62.
- Zhang Z, Fan W, Yang G, et al. Risk of tuberculosis in patients treated with TNF-α antagonists: a systematic review and metaanalysis of randomised controlled trials. BMJ Open 2017;7:e012567. doi:10.1136/bmjopen-2016-012567.
- Gómez-Reino JJ, Carmona L, Valverde VR, Mola EM, Montero MD; BIOBADASER Group. Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report. Arthritis Rheum 2003 Aug;48(8):2122-7.
- Elbek O, Uyar M, Aydin N, et al. Increased risk of tuberculosis in patients treated with antitumor necrosis factor alpha. Clin Rheumatol 2009 Apr;28(4):421-6.
- Mutlu P, Sevinç C, Kılınç O, Uçan ES. Follow up results of latent tuberculosıs ınfectıon ın patıents treated wıth antı-TNF-alpha. Nobel Med 2014;10(1):47-52.
- Doğan C, Kıral N, Cömert SŞ, Fidan A, Çağlayan B, Salepçi B. Tuberculosis frequency in patients taking TNF-alpha blockers. Turk Thorac J 2012; 13: 93-8.
- Borekci S, Atahan E, Demir Yilmaz D, et al. Factors affecting the tuberculosis risk in patients receiving anti-tumor necrosis factor-α treatment. Respiration 2015;90(3):191-8.
- T.C. Sağlık Bakanlığı anti-TNF kullanan hastalarda tüberküloz rehberi, 2016.
Öz
There are increasing data available about use of biologic agents in treatment of systemic inflammatory rheumatologic disorders. Currently reported noninfectious pulmonary complications related to biologic agents use include most commonly granulomatous disease and interstitial lung disease. In addition, the most serious adverse events from these drugs are respiratory infections, especially bacterial pneumonia, tuberculosis, and Pneumocystis jirovecii pneumonia. Treatment with biologic agents, in particular tumor necrosis factor alpha (TNF-α) inhibitors, is associated with an increased risk of tuberculosis. Screening and treatment for latent tuberculosis infection in patients undergoing such treatment is therefore indicated
Anahtar Kelimeler
Biological agents pulmonary pneumonia tuberculosis treatment
Kaynakça
- Nakajima A, Saito K, Kojima T, et al. No increased mortality in patients with rheumatoid arthritis treated with biologics: results from the biologics register of six rheumatology institutes in Japan. Mod Rheumatol 2013 Sep;23(5):945-52. doi: 10.1007/s10165-012-0773-z.
- Greenberg JD, Reed G, Kremer JM, et al; CORRONA Investigators. Association of methotrexate and tumour necrosis factor antagonists with risk of infectious outcomes including opportunistic infections in the CORRONA registry. Ann Rheum Dis 2010 Feb;69(2):380-6.
- Takayanagi N. Biological agents and respiratory infections: Causative mechanisms and practice management. Respir Investig 2015 Sep;53(5):185-200.
- Lanternier F, Tubach F, Ravaud P, et al; Research Axed on Tolerance of Biotherapies Group. Incidence and risk factors of Legionella pneumophila pneumonia during anti-tumor necrosis factor therapy: a prospective French study. Chest 2013 Sep;144(3):990-8.
- Vallabhaneni S, Chiller TM. Fungal infections and new biologic therapies. Curr Rheumatol Rep 2016 May;18(5):29. doi: 10.1007/s11926-016-0572-1.
- Kılıç E, Kılıç G, Akgül Ö, Akgöl G, Özgöçmen S. The Reported Adverse Effects Related to Biological Agents Used for the Treatment of Rheumatic Diseases in Turkey. Turk J Rheumatol 2013;28(3):149-62.
- Zhang Z, Fan W, Yang G, et al. Risk of tuberculosis in patients treated with TNF-α antagonists: a systematic review and metaanalysis of randomised controlled trials. BMJ Open 2017;7:e012567. doi:10.1136/bmjopen-2016-012567.
- Gómez-Reino JJ, Carmona L, Valverde VR, Mola EM, Montero MD; BIOBADASER Group. Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report. Arthritis Rheum 2003 Aug;48(8):2122-7.
- Elbek O, Uyar M, Aydin N, et al. Increased risk of tuberculosis in patients treated with antitumor necrosis factor alpha. Clin Rheumatol 2009 Apr;28(4):421-6.
- Mutlu P, Sevinç C, Kılınç O, Uçan ES. Follow up results of latent tuberculosıs ınfectıon ın patıents treated wıth antı-TNF-alpha. Nobel Med 2014;10(1):47-52.
- Doğan C, Kıral N, Cömert SŞ, Fidan A, Çağlayan B, Salepçi B. Tuberculosis frequency in patients taking TNF-alpha blockers. Turk Thorac J 2012; 13: 93-8.
- Borekci S, Atahan E, Demir Yilmaz D, et al. Factors affecting the tuberculosis risk in patients receiving anti-tumor necrosis factor-α treatment. Respiration 2015;90(3):191-8.
- T.C. Sağlık Bakanlığı anti-TNF kullanan hastalarda tüberküloz rehberi, 2016.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Ek |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Ekim 2019 |
| Gönderilme Tarihi | 19 Ekim 2018 |
| Yayımlandığı Sayı | Yıl 2019Cilt: 58 Özel Sayı: 1 (Romatoloji) |
