title: [Guidelines in RA treatment: concepts on safety and recommendations using anti-TNF-alpha inhibitors. Grupo de Estudio de Nuevas Terapias de Enfermedades reumáticas (GENTE)].
abstract: Recommendations for the use of Disease-Modifying Antirheumatic Drugs (DMARD) with both conventional and biological agents in Rheumatoid Arthritis (RA) must be based on their safety profile, adverse effects, risks, and advantages. With the purpose of presenting the most updated information about the safety of tumor necrosis factor alpha (TNFalpha) antagonists, in this article we summarize the literature published during the last three years about this sort of biological agents in specific clinical situations, such as risk of developing infections, cancer, cardiovascular diseases, and autoimmunity; as well as their administration to patients who will undergo surgical procedures, pregnant and/or breast-feeding women, and patients who need immunizations. Likewise, in this analysis we offer specific recommendations, based on evidence, for the best anti-TNF-alfa management.
authors.affiliation: Facultad de Medicina Universidad Nacional Autónoma de México, Hospital Angeles Lomas. diazj@iname.com
authors.forename: Efraín
authors.initials: E
authors.lastname: Díaz-Jouanen
authors.forename: Carlos
authors.initials: C
authors.lastname: Abud-Mendoza
authors.forename: Mario Alberto
authors.initials: MA
authors.lastname: Garza-Elizondo
authors.forename: Gabriel
authors.initials: G
authors.lastname: Medrano-Ramírez
authors.forename: Rubén
authors.initials: R
authors.lastname: Burgos-Vargas
authors.forename: José Javier
authors.initials: JJ
authors.lastname: Orozco-Alcalá
authors.forename: César Francisco
authors.initials: CF
authors.lastname: Pacheco-Tena
authors.forename: Carlos
authors.initials: C
authors.lastname: Pineda
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Pozos-Espíndola
authors.forename: Francisco
authors.initials: F
authors.lastname: Ramos-Niembro
authors.forename: Manuel
authors.initials: M
authors.lastname: Robles-San-Román
authors.forename: Jesús Ernesto
authors.initials: JE
authors.lastname: Santana-Sahagún
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology; D002648:Child; D002986:Clinical Trials as Topic; D003141:Communicable Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007114:Immunization; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007774:Lactation; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000188:drug therapy; D011300:Preoperative Care; D012306:Risk; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha