非肿瘤坏死因子靶向药物治疗类风湿关节炎的结核感染风险研究进展

类风湿关节炎是一种常见的慢性、炎症性自身免疫性疾病,多年来肿瘤坏死因子抑制剂(tumour necrosis factor inhibitors,TNFi)的应用为类风湿关节炎的治疗带来了划时代的进步,但其导致的不良风险,尤其是引起活动性结核病的发病率明显增加,越来越引起关注。而近年来非肿瘤坏死因子靶向药物治疗类风湿关节炎取得了良好的疗效,且越来越多的研究表明其引起活动性结核病的风险低于TNFi。笔者将对非肿瘤坏死因子靶向药物在治疗类风湿关节炎中的结核病风险进行综述,有助于指导存在结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)的类风湿关节炎患者和结核病高流行地区的类风湿关节炎患者的药物选择。

The risk of tuberculosis infection with non-tumor necrosis factor-targeted drugs in the treatment of rheumatoid arthritis

Rheumatoid arthritis (RA) is a common chronic, inflammatory autoimmune disease. Over the years, the application of tumor necrosis factor inhibitors (TNFi) has brought epoch-making progress to the treatment of RA, but its adverse risk, especially the significantly increased incidence of active tuberculosis, has attracted more and more attention. Recently, non-tumor necrosis factor (TNF)-targeted drugs have achieved good efficacy in the treatment of RA, more and more studies have shown that it caused the risk of active tuberculosis is lower than that of TNFi. This article will discuss the risk of tuberculosis infection with non-TNF-targeted drugs in the treatment of RA,which helps determine drug options for RA patients with latent tuberculosis infection (LTBI) and RA patients in geographical regions with a high prevalence of tuberculosis.