[甲氨蝶呤联合英夫利昔单抗治疗类风湿关节炎孕妇]。

Reumatizam Pub Date : 2016-01-01
Marija Bakula, Mislav Cerovec, Krešimir Rukavina, Nada Čikeš, Branimir Anić
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引用次数: 0

摘要

肿瘤坏死因子- α抑制剂已成为类风湿关节炎患者的一种既定治疗方案。考虑到它们的潜在危害,它们被归类为B类药物。动物繁殖研究未能证明对胎儿有风险,也没有对孕妇进行充分和良好控制的研究。改善疾病的抗风湿药物(DMARDs)常与生物疗法联合使用,甲氨蝶呤治疗已显示出良好的效果。该抗代谢物被列为X类药物,其致畸作用是众所周知的。炎症性风湿病在妇女中的发病率明显较高。有许多关于孕妇接受生物治疗的报道,甚至经常与DMARDs联合使用。这种疗法对生殖健康的影响是一个争论的主题,在这个问题上有争议的观点。我们报告一位在妊娠31周时发现怀孕的类风湿关节炎患者。在此期间,她曾接受甲氨蝶呤和英夫利昔单抗治疗,无不良反应。
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[Pregnant patient with rheumatoid arthritis treated with methotrexate and infliximab].

Tumor necrosis factor-alpha inhibitors have become an established therapeutic regimen for patients with rheumatoid arthritis. Regarding their harmful potential they are classified as category B medications. Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. Disease-modifying antirheumatic drugs (DMARDs) are often used in combination with biological therapy and treatment with methotrexate has shown good results. This antimetabolite is classified as a category X drug and its teratogenic effect is well known. The incidence of inflammatory rheumatic diseases is significantly higher in women. There are many reports on pregnant patients treated with biological therapy, oft en in combination with DMARDs. The effects of such a therapy on reproductive health is a theme of debate, with controversial views on the matter. We present a patient with rheumatoid arthritis whose pregnancy was discovered at 31 weeks of gestation. During that period she had been treated with methotrexate and infliximab, with no adverse effects.

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