Safety of anti-tumor necrosis factor therapy in inflammatory bowel disease

查看全文 作　　者：Frank [1]Hoentjen;Ad A van [1]Bodegraven

机构地区：[1]Department of Gastroenterology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands

出　　处：《World Journal of Gastroenterology》索引2009年第15卷第17期,共7页

摘　　要：Inflammatory bowel disease (IBD), in particular Crohn's disease refractory to conventional therapy, fistulizing Crohn's disease and chronic active ulcerative colitis, generally respond well to anti-tumor necrosis factor (TNF) therapy. However, serious side effects do occur, necessitating careful monitoring of therapy. Potential side effects of anti-TNF therapy include opportunistic infections, which show a higher incidence when concomitant immunosuppression is used. Furthermore, antibody formation against anti-TNF is associated with decreased efficacy and an increased frequency of infusion reactions. The hypothesis of a slightly increased risk of lymphomas in IBD patients treated with anti TNF-therapy is debatable, since most studies lack the specific design to properly address this issue. Alarmingly, the occurrence of hepatosplenic T-cell lymphomas coincides with combined immunosuppressive therapy. Despite the potential serious side effects, anti-TNF therapy is an effective and relatively safe treatment option for refractory IBD. Future research is needed to answer important questions, such as the long-term risk of malignancies, safety during pregnancy, when to discontinue and when to switch anti-TNF therapy, as well as to determine the balance between therapeutic and toxic effects. 关键词：抗肿瘤坏死因子疗法常规治疗炎症性肠病相对安全肝脾T细胞淋巴瘤传染性法氏囊病免疫抑制治疗溃疡性结肠炎

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Safety of anti-tumor necrosis factor therapy in inflammatory bowel disease

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