mais doenças malignas, principalmente nos pulmões ou, cabeça e pescoço, no grupo de doentes tratados com infliximab do que no grupo controlo de doentes. [Bula]. Princeton: Bristol-Myers Squibb; : National Institutes of Health The incidence and management of infusion reactions to infliximab: a large center . Infliximab may be a useful adjuvant in the treatment of retinal detachment. Mohammad Hosein .. Arroyo JG, Yang L, Bula D, Chen DF. Photoreceptor apoptosis.
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Psoriasis is immune-mediated chronic inflammatory disease with preference for skin and joints. The skin involvement occurs by hyperproliferation and abnormal differentiation of keratinocytes. It is associated with comorbidities, mainly related to the clinical manifestations of the metabolic syndrome.
A lot of infusion reactions have been described in the literature.
To evaluate the adverse effects of intravenous treatment with infliximab, analyzing patients with psoriasis compared to those with other chronic inflammatory diseases rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis. Analysis of medical records and adverse events of patients undergoing infliximab infusion bulq psoriasis and chronic inflammatory diseases treatment.
Infliximab is a safe drug, with a low percentage of adverse events and there were more adverse events in women with chronic inflammatory diseases and in patients who received more infliximab infusions. It leads to a negative impact on patient’s quality of life and is associated with decreased productivity, depression, alcoholism, smoking and increased prevalence of neoplastic disease. It is considered a chronic inflammatory disease with a predilection for skin and joints, nifliximab multifactorial etiology and genetic and environmental influence, which is characterized by involvement of the skin by hyperproliferation and abnormal differentiation of keratinocytes, and it is immunologically mediated Th1.
The disease is associated with comorbidities, especially those related to clinical manifestations of the metabolic syndrome, beyond spondyloarthropathies, uveitis and inflammatory bowel syndromes. Among these drugs, infliximab has been highlighted.
Treatment modalities for psoriasis are chosen according to disease severity, comorbidities, patient preference including cost and convenienceeffectiveness and individual assessment of response to treatment. Patients with moderate to severe psoriasis plaques should initially be treated with phototherapy and, in the presence of contraindications or failure, a systemic treatment agent should be indicated, such as infliximab. The contraindications to the use of infliximab should be considered, such as hypersensitivity to the drug, known by the patient, localized or systemic active infections, infection with human immunodeficiency virus, congestive heart failure with functional class III or IV according to the New York Heart Association, history of demyelinating disease, history of cancer except when there was no recurrence in the last 5 years and in the case of bla with basal cell carcinoma and history of systemic lupus erythematosus.
Live attenuated vaccines should not be given during treatment. In addition to these more common reactions, others have been reported and can occur during or after the infusion, such as induction and exacerbation of psoriasis, induction of pityriasis lichenoides chronica, formation of anti-DNA antibodies, lupus-like syndrome, malignancies, reactivation of tuberculosis primary focus, and alopecia. With inflixiimab this observations, we can see that the study of adverse events is of utmost importance for its greater understanding and a subsequent attempt to minimize or control them.
This is a retrospective cross-sectional study. inffliximab
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Adverse events, as well as type of disease, sex, age and number of infliximab infusions, were collected and stored in an Excel spreadsheet buoa subjected to statistical analysis. The nominal qualitative variables were compared with the help of the Chi-square test and Fisher’s exact test. The continuous quantitative variables with Gaussian distribution were analyzed with the help of the unpaired t test.
In the case of quantitative variables without Gaussian distribution, we used the nonparametric Mann-Whitney test. All tests were applied with the assistance of the program StatsDirect Statistical Software 1.
Of the patients evaluated using infliximab, 24 had psoriasis, 2 of them had arthritis associated with skin lesion and had chronic inflammatory diseases amenable to treatment with infliximab rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis. Of psoriasis patients, only 2 8. One of them had lupus-like reaction and the other patient had an anaphylactic reaction. Of the patients with chronic inflammatory diseases CID6 4.
In all cases, the suspension of the treatment was needed Table 1. Regarding gender, 75 Of psoriasis patients, with or without arthritis, 13 In the group of patients with other chronic inflammatory diseases, 64 were men There was no statistically significant difference in gender or age when comparing the groups of indliximab psoriasis versus chronic inflammatory diseases Table 2.
Number of infusions in the group with no adverse events G2 in relation to the number infliximsb the group with reactions G1. Regarding the frequency of infusions, among the 8 patients that presented adverse events, Statistical analysis of this data was hampered by lack of sufficient data for analysis of the total sample records.
Several studies demonstrate the inflixi,ab reactions resulting from infliximab administration in the treatment of both psoriasis and other chronic inflammatory diseases, justifying the importance of the study and prevention of such reactions. Symptoms described in inrliximab literature, such as arthralgia, myalgia, influenza-like symptoms, headache, fatigue, induction and exacerbation of psoriasis, induction of pityriasis lichenoides chronica, formation of anti-DNA antibodies or reactivation of tuberculosis primary focus, wasn’t observed in the results presented here.
The profile of infusion reactions of patients studied here does not include some reactions already described, such as the correlation between treatment with infliximab and the development of malignancies, or cases of palmoplantar pustulosis 4 induced by treatment with the monoclonal antibody in patients with psoriasis or other chronic inflammatory diseases.
There were also no reports of exacerbation of clinical findings after treatment or induction of pityriasis lichenoides chronica. There are reports in the literature of a type of adverse event called serum sickness-like, a type of hypersensitivity reaction, resulting from deposit in the tissues of circulating antigen-antibody complex formed after the infusion of the drug.
There were no reports of such reactions in patients analyzed in this study. Recent studies on the influence of gender on the frequency of adverse events are imfliximab and controversial. However, some studies corroborate the data, showing more reactions in women and highlighting the female gender as a risk factor for infusion reactions. This finding contradicts recent studies that observed more infusion reactions during the first infusion of the medication, showing a drop in the frequency of reactions according to the increase of the number of infusions in patients.
We can consider as a bias of this study the absence of sufficient data to conduct comparative analysis between delayed infusions and frequency of adverse events. It is known that a long interval between infusions is a risk factor for infusion reactions, and long periods without treatment result in higher incidences of serious infusion reactions.
It can be concluded that infliximab is a safe drug, with a low percentage of adverse events, but with peculiarities in relation to the studied parameters.
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We demonstrated the presence of a higher percentage of adverse events in women with inflammatory bowel diseases amenable to treatment with infliximab, but there is no clinical significance in comparative analysis between gender and frequency of reactions in psoriasis group. It is also observed in the study, a higher frequency of adverse events in patients who underwent a greater number of infusions. More studies are necessary to corroborate previous findings infliximba the subject. National Center for Biotechnology InformationU.
Journal List An Bras Dermatol v. Find articles by Jessica Sanmiguel. Find articles by Invliximab Viotto Cagnon. Find articles by Moacir Fernandes de Godoy. Find articles by Eurides Maria Oliveira Pozetti.
Author information Article notes Copyright and License information Disclaimer. Received Dec 10; Accepted Sep 4.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited. Abstract Background Psoriasis is immune-mediated chronic inflammatory disease with preference for skin and joints. Objective To evaluate the adverse effects of intravenous treatment with infliximab, analyzing patients with psoriasis compared to those with other chronic inflammatory diseases rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis.
Method Analysis of medical records and adverse events inflixlmab patients undergoing infliximab infusion for psoriasis and chronic inflammatory diseases treatment. Results patients who have used infliximab were evaluated, 24 had psoriasis and had chronic inflammatory diseases. Conclusion Infliximab is a safe drug, with a low percentage of adverse events and there were more adverse events in women with chronic inflammatory diseases and in patients who received more infliximab infusions.
Arthritis, rheumatoid; Crohn disease; Proctocolitis; Psoriasis. RESULTS Of the patients evaluated using infliximab, 24 had psoriasis, 2 of them had arthritis associated with skin lesion and had chronic inflammatory diseases amenable to treatment with infliximab vula arthritis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis. Open in a separate window. Sociedade Brasileira de Dermatologia. Sociedade Brasileira de Dermatologia; Treatments for psoriasis and the risk of malignancy.
J Am Acad Dermatol. Development of new-onset psoriasis in a patient receiving infliximab for treatment of rheumatoid arthritis. Manifestation of palmoplantarpustulosis during or after infliximab therapy for plaque-type psoriasis: Efficacy of infliximab in patients with moderate and severe psoriasis treated with infliximab Remicade Rev Infliximsb Chil.
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Infliximab indution and maintenance therapy for moderate-to-severe psoriasis: Infliximab for treatment of psoriasis. Expert Opin Biol Ther. Tumor necrosis factor-alpha inflixkmab An overview of adverse effects. Risk of bacterial, viral, and fungal infections.
Review and expert opinion on prevention and treatment of infliximab-related infusion reactions. Infliximabeinditiontherapy for pacients with severe plaque types psoriasis: Cheifetz A, Mayer L. Monoclonal antibodies, immunogenicity, and associated infusion reactions.
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Infusion reactions to infliximab in children and adolescents: The influence of sex and drugs. N Engl J Med. Cullen G, Cheifetz AS. Infusion reactions related to Infliximab therapy are not usually associated with drug discontinuation. Safety of infliximab tratment in patients with rheumatoid arthritis in a real-wold clinical setting: Description and evaluation of infusion reactions.
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