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Lymphoprolipherative skin reactions induced by anti-TNFα: an open question.

抗tnf α 诱导的淋巴滞留性皮肤反应: 一个悬而未决的问题。

  • 影响因子:1.76
  • DOI:10.1080/09546634.2019.1579889
  • 作者列表:"Nikolaou V","Gerochristou M","Marinos L","Economidi A","Voudouri D","Rigopoulos D","Stratigos AJ
  • 发表时间:2020-02-01
Abstract

:Although anti-TNFα agents have revolutionized the treatment of many inflammatory diseases, various concerns have been reported regarding the risks of cancer development, as well as acceleration of the progression of subclinical, preexisting malignancies. In this case series, we investigated the provocative effect of anti-TNFα drugs in the development of cutaneous mycosis fungoides (MF)-like lymphoproliferative reactions. We describe five patients aged between 25-63 diagnosed with autoimmune disorders (psoriatic arthritis - one patient, Crohn's disease - one patient and ankylosing spondylitis - three patients) who received anti-TNFα agents before the development of a cutaneous lymphoproliferative reaction. Histological and immunophenotypical analysis was typical for mycosis fungoides in all of them. Anti-TNFα agents were stopped with regression of the skin rash. A direct effect of anti-TNFα agents in the development of lymphoproliferative reactions (including MF) is suggested and further analyzed. Treatment cessation can be therapeutic.

摘要

虽然抗tnf α 药物已经彻底改变了许多炎症性疾病的治疗,但已经报道了关于癌症发展风险以及加速亚临床、先前存在的恶性肿瘤进展的各种担忧。在本病例系列中,我们研究了抗tnf α 药物在皮肤蕈样肉芽肿 (MF) 样淋巴增生反应发生中的激发作用。我们描述了 5 例年龄在 25-63 岁之间诊断为自身免疫性疾病的患者 (银屑病关节炎-1 例患者,克罗恩病-1 例患者和强直性脊柱炎-3 例患者) 在发生皮肤淋巴增生反应之前接受了抗tnf α 药物。所有患者的蕈样肉芽肿的组织学和免疫表型分析都是典型的。随着皮疹消退,停用抗tnf α 药物。建议并进一步分析抗tnf α 药物在淋巴增生反应 (包括MF) 发展中的直接作用。停止治疗可以是治疗性的。

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作者列表:["Beltai A","Barnetche T","Daien C","Lukas C","Gaujoux-Viala C","Combe B","Morel J"]

METHODS:OBJECTIVE:Patients with immune-mediated inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus are at increased risk of cardiovascular disease. However, the cardiovascular risk of patients with primary Sjögren's syndrome (SS) remains poorly studied. We aimed to investigate the association between primary SS and cardiovascular morbidity and mortality. METHODS:We performed a systematic review of articles in Medline and the Cochrane Library and recent abstracts from US and European meetings, searching for reports of randomized controlled studies of cardiovascular morbidity and cardiovascular mortality in primary SS. The relative risk (RR) values for cardiovascular morbidity and mortality associated with primary SS were collected and pooled in a meta-analysis with a random-effects model by using Review Manager (Cochrane collaboration). RESULTS:The literature search revealed 484 articles and abstracts of interest; 14 studies (67,124 patients with primary SS) were included in the meta-analysis. With primary SS versus control populations, the risk was significantly increased for coronary morbidity (RR 1.34 [95% confidence interval (95% CI) 1.06-1.38]; P = 0.01), cerebrovascular morbidity (RR 1.46 [95% CI 1.43-1.49]; P < 0.00001), heart failure rate (odds ratio 2.54 [95% CI 1.30-4.97]; P < 0.007), and thromboembolic morbidity (RR 1.78 [95% CI 1.41-2.25]; P < 0.00001), with no statistically significant increased risk of cardiovascular mortality (RR 1.48 [95% CI 0.77-2.85]; P = 0.24). CONCLUSION:This meta-analysis demonstrates that primary SS is associated with increased cardiovascular morbidity, which suggests that these patients should be screened for cardiovascular comorbidities and considered for preventive interventions, in a multidisciplinary approach with cardiologists.

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23827
作者列表:["Lee RR","Rashid A","Thomson W","Cordingley L"]

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