[Anti-cytokines in the treatment of inflammation].
Tumour necrosis factor (TNF) alpha and interleukine 1 (IL-1) have a pro-inflammatory effect in all targets of the body. However, every inflammatory disease is characterized by a peculiar profile of secretion of cytokines. TNF alpha blocking agents are a major advance in the treatment of of rheumatoid arthritis, spondylarthropathies and Crohn disease. To date, the most common adverse events are reactions to infusions and reactivation of active tuberculosis with infliximab. Association of another immunosuppressive drug, such as methotrexate, decreases the first of these adverse events. IL1-RA is an inhibitor of IL-1 effects which have demonstrated its efficiency in rheumatoid arthritis. These anticytokines represent a dramatic progress in the treatment of inflammatory diseases but we have to stay very careful concerning the possible increased risk of infection or cancer.
Mariette
Xavier
X
Service de rhumatologie Hôpital de Bicêtre 94275 Le Kremlin-Bicêtre. xavier.mariette@bct.ap-hop-paris.fr
D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy*; D006801:Humans; D007239:Infections / Q000209:etiology; D007249:Inflammation / Q000188:drug therapy*; D000069285:Infliximab; D007375:Interleukin-1 / Q000037:antagonists & inhibitors*; D009369:Neoplasms / Q000209:etiology; D012307:Risk Factors; D000093242:Interleukin-6 Inhibitors
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab; D007375:Interleukin-1; D000093242:Interleukin-6 Inhibitors