[Guidelines in RA treatment: concepts on safety and recommendations using anti-TNF-alpha inhibitors. Grupo de Estudio de Nuevas Terapias de Enfermedades reumáticas (GENTE)].
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.
Díaz-Jouanen
Efraín
E
Facultad de Medicina Universidad Nacional Autónoma de México, Hospital Angeles Lomas. diazj@iname.com
Abud-Mendoza
Carlos
C
Garza-Elizondo
Mario Alberto
MA
Medrano-Ramírez
Gabriel
G
Burgos-Vargas
Rubén
R
Orozco-Alcalá
José Javier
JJ
Pacheco-Tena
César Francisco
CF
Pineda
Carlos
C
Pozos-Espíndola
Juan Carlos
JC
Ramos-Niembro
Francisco
F
Robles-San-Román
Manuel
M
Santana-Sahagún
Jesús Ernesto
JE
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*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha