A guide to preparation of patients with inflammatory bowel diseases for anti-TNF-alpha therapy

Detalhes bibliográficos
Autor(a) principal: Fonseca Chebli, Julio Maria
Data de Publicação: 2014
Outros Autores: Gaburri, Pedro Duarte, Chebli, Liliana Andrade, Rocha Ribeiro, Tarsila Campanha da, Tavares Pinto, Andre Luiz, Ambrogini Junior, Orlando [UNIFESP], Mourao Cintra Damiao, Aderson Omar
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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spelling 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
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