A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.12659/MSM.890331 http://repositorio.unifesp.br/handle/11600/44877 |
Resumo: | Current therapy of moderate-to-severe inflammatory bowel disease (IBD) often involves the use of anti-tumor necrosis factor alpha (TNF-alpha) agents. Although very effective, theses biologics place the patient at increased risk for developing infections and lymphomas, the latter especially when in combination with thiopurines. Appropriate patient selection, counseling, and education are all important features for the successful use of anti-TNF-alpha therapy. A thorough history to rule-out contraindications of this therapy and emphasis on monitoring guidelines are important steps preceding administration of anti-TNF-alpha agents. This therapy should only be considered if a recent evaluation has established that the patient has active IBD. In addition, it is important to exclude disease mimickers. Anti-TNF-alpha agents have been considered to present a globally favorable benefit/risk ratio. However, it is important that in routine practice, initiation of anti-TNF-alpha therapy be carefully discussed with the patient, extensively explaining the potential benefits and risks of such treatment. Prior to starting anti-TNF-alpha therapy, the patients need to be screened for latent tuberculosis, hepatitis B virus infection, and (usually) hepatitis C virus and HIV infection. Vaccination schedules of IBD patients should be evaluated and updated prior to the commencement of anti-TNF-alpha therapy. Ordinarily, immunization in adult patients with IBD should not deviate from recommended guidelines for the general population. With the exception of live vaccines, immunizations can be safely administered in patients with IBD, even those on immunosuppressants or biologics. The purpose of this review is providing an overview of appropriate steps to prepare patients with IBD for anti-TNF-alpha therapy. |
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A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapyInflammatory Bowel DiseaseUlcerative ColitisAgents, BiologicalCurrent therapy of moderate-to-severe inflammatory bowel disease (IBD) often involves the use of anti-tumor necrosis factor alpha (TNF-alpha) agents. Although very effective, theses biologics place the patient at increased risk for developing infections and lymphomas, the latter especially when in combination with thiopurines. Appropriate patient selection, counseling, and education are all important features for the successful use of anti-TNF-alpha therapy. A thorough history to rule-out contraindications of this therapy and emphasis on monitoring guidelines are important steps preceding administration of anti-TNF-alpha agents. This therapy should only be considered if a recent evaluation has established that the patient has active IBD. In addition, it is important to exclude disease mimickers. Anti-TNF-alpha agents have been considered to present a globally favorable benefit/risk ratio. However, it is important that in routine practice, initiation of anti-TNF-alpha therapy be carefully discussed with the patient, extensively explaining the potential benefits and risks of such treatment. Prior to starting anti-TNF-alpha therapy, the patients need to be screened for latent tuberculosis, hepatitis B virus infection, and (usually) hepatitis C virus and HIV infection. Vaccination schedules of IBD patients should be evaluated and updated prior to the commencement of anti-TNF-alpha therapy. Ordinarily, immunization in adult patients with IBD should not deviate from recommended guidelines for the general population. With the exception of live vaccines, immunizations can be safely administered in patients with IBD, even those on immunosuppressants or biologics. The purpose of this review is providing an overview of appropriate steps to prepare patients with IBD for anti-TNF-alpha therapy.Univ Fed Juiz de Fora, Div Gastroenterol, Ctr Inflammatory Bowel Dis, Juiz De Fora, BrazilFed Univ Sao Paulo UNIFESP, Div Gastroenterol, Sao Paulo, BrazilUniv Sao Paulo, Sch Med, Hosp Clin, Lab Med Invest LIM 07, Sao Paulo, BrazilFed Univ Sao Paulo UNIFESP, Div Gastroenterol, Sao Paulo, BrazilWeb of ScienceConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Int Scientific Literature, IncUniv Fed Juiz de ForaUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)Fonseca Chebli, Julio MariaGaburri, Pedro DuarteChebli, Liliana AndradeRocha Ribeiro, Tarsila Campanha daTavares Pinto, Andre LuizAmbrogini Junior, Orlando [UNIFESP]Mourao Cintra Damiao, Aderson Omar2018-06-18T11:03:59Z2018-06-18T11:03:59Z2014-03-26info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion487-498http://dx.doi.org/10.12659/MSM.890331Medical Science Monitor. Smithtown: Int Scientific Literature, Inc, v. 20, p. 487-498, 2014.10.12659/MSM.8903311643-3750http://repositorio.unifesp.br/handle/11600/44877WOS:000333418100001engMedical Science Monitorinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-05-02T15:52:35Zoai:repositorio.unifesp.br/:11600/44877Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-05-02T15:52:35Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
title |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
spellingShingle |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy Fonseca Chebli, Julio Maria Inflammatory Bowel Disease Ulcerative Colitis Agents, Biological |
title_short |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
title_full |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
title_fullStr |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
title_full_unstemmed |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
title_sort |
A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy |
author |
Fonseca Chebli, Julio Maria |
author_facet |
Fonseca Chebli, Julio Maria Gaburri, Pedro Duarte Chebli, Liliana Andrade Rocha Ribeiro, Tarsila Campanha da Tavares Pinto, Andre Luiz Ambrogini Junior, Orlando [UNIFESP] Mourao Cintra Damiao, Aderson Omar |
author_role |
author |
author2 |
Gaburri, Pedro Duarte Chebli, Liliana Andrade Rocha Ribeiro, Tarsila Campanha da Tavares Pinto, Andre Luiz Ambrogini Junior, Orlando [UNIFESP] Mourao Cintra Damiao, Aderson Omar |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Univ Fed Juiz de Fora Universidade Federal de São Paulo (UNIFESP) Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Fonseca Chebli, Julio Maria Gaburri, Pedro Duarte Chebli, Liliana Andrade Rocha Ribeiro, Tarsila Campanha da Tavares Pinto, Andre Luiz Ambrogini Junior, Orlando [UNIFESP] Mourao Cintra Damiao, Aderson Omar |
dc.subject.por.fl_str_mv |
Inflammatory Bowel Disease Ulcerative Colitis Agents, Biological |
topic |
Inflammatory Bowel Disease Ulcerative Colitis Agents, Biological |
description |
Current therapy of moderate-to-severe inflammatory bowel disease (IBD) often involves the use of anti-tumor necrosis factor alpha (TNF-alpha) agents. Although very effective, theses biologics place the patient at increased risk for developing infections and lymphomas, the latter especially when in combination with thiopurines. Appropriate patient selection, counseling, and education are all important features for the successful use of anti-TNF-alpha therapy. A thorough history to rule-out contraindications of this therapy and emphasis on monitoring guidelines are important steps preceding administration of anti-TNF-alpha agents. This therapy should only be considered if a recent evaluation has established that the patient has active IBD. In addition, it is important to exclude disease mimickers. Anti-TNF-alpha agents have been considered to present a globally favorable benefit/risk ratio. However, it is important that in routine practice, initiation of anti-TNF-alpha therapy be carefully discussed with the patient, extensively explaining the potential benefits and risks of such treatment. Prior to starting anti-TNF-alpha therapy, the patients need to be screened for latent tuberculosis, hepatitis B virus infection, and (usually) hepatitis C virus and HIV infection. Vaccination schedules of IBD patients should be evaluated and updated prior to the commencement of anti-TNF-alpha therapy. Ordinarily, immunization in adult patients with IBD should not deviate from recommended guidelines for the general population. With the exception of live vaccines, immunizations can be safely administered in patients with IBD, even those on immunosuppressants or biologics. The purpose of this review is providing an overview of appropriate steps to prepare patients with IBD for anti-TNF-alpha therapy. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-03-26 2018-06-18T11:03:59Z 2018-06-18T11:03:59Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.12659/MSM.890331 Medical Science Monitor. Smithtown: Int Scientific Literature, Inc, v. 20, p. 487-498, 2014. 10.12659/MSM.890331 1643-3750 http://repositorio.unifesp.br/handle/11600/44877 WOS:000333418100001 |
url |
http://dx.doi.org/10.12659/MSM.890331 http://repositorio.unifesp.br/handle/11600/44877 |
identifier_str_mv |
Medical Science Monitor. Smithtown: Int Scientific Literature, Inc, v. 20, p. 487-498, 2014. 10.12659/MSM.890331 1643-3750 WOS:000333418100001 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Medical Science Monitor |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
487-498 |
dc.publisher.none.fl_str_mv |
Int Scientific Literature, Inc |
publisher.none.fl_str_mv |
Int Scientific Literature, Inc |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
_version_ |
1814268267057905664 |