抗肿瘤坏死因子治疗克罗恩病并发腹腔脓肿

Nicola Humphry
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引用次数: 0

摘要

过量生产TNF-α导致慢性炎症和组织损伤免疫介导的炎症性疾病(IMID),如克罗恩病(CD),类风湿性关节炎和牛皮癣。抗tnf药物的引入彻底改变了IMIDs患者的治疗方法,目前欧洲已批准两种抗tnf药物用于CD:英夫利昔单抗和阿达木单抗。与乳糜泻相关的慢性跨壁炎症通常会导致肠道并发症,如腹内脓肿,这对多学科医疗团队来说是一个挑战。虽然一些患者最终可能需要手术治疗,但手术治疗与发病和功能丧失的风险相关,特别是对于需要免疫抑制来治疗潜在CD的患者。这篇小型综述总结了目前关于在CD合并腹腔脓肿中使用抗肿瘤坏死因子的证据,包括目前的治疗指南、抗肿瘤坏死因子联合保守(非手术)治疗的证据。抗肿瘤坏死因子对术后并发症及脓肿复发的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anti-TNF Treatment in Crohn’s Disease Complicated by Intra-abdominal Abscess
Excess production of TNF-α leads to chronic inflammation and tissue damage in immune-mediated inflammatory diseases (IMID) such as Crohn’s Disease (CD), rheumatoid arthritis, and psoriasis. The introduction of anti-TNF agents revolutionised therapy for patients with IMIDs, and two anti-TNFs are currently approved for use in CD in Europe: infliximab and adalimumab. The chronic transmural inflammation associated with CD commonly leads to intestinal complications such as intra-abdominal abscesses, which present a challenge to a multidisciplinary medical team. While surgical management may ultimately be required in some patients, it is associated with a risk of morbidity and loss of function, particularly in a patient who requires immunosuppression to address their underlying CD. This mini review summarises the current evidence surrounding the use of anti-TNFs in CD complicated by intra-abdominal abscess, including current treatment guidelines, the use of anti-TNFs in combination with conservative (non-surgical) management, and the impact of anti-TNFs on post-operative complications and abscess recurrence.
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