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Clinics ; 68(9): 1189-1196, set. 2013. tab, graf
Article Dans Anglais | LILACS | ID: lil-687760

Résumé

OBJECTIVE: We evaluated the incidence of and the main risk factors associated with cutaneous adverse events in patients with chronic inflammatory arthritis following anti-TNF-α therapy. METHODS: A total of 257 patients with active arthritis who were taking TNF-α blockers, including 158 patients with rheumatoid arthritis, 87 with ankylosing spondylitis and 12 with psoriatic arthritis, were enrolled in a 5-year prospective analysis. Patients with overlapping or other rheumatic diseases were excluded. Anthropometric, socioeconomic, demographic and clinical data were evaluated, including the Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index and Psoriasis Area Severity Index. Skin conditions were evaluated by two dermatology experts, and in doubtful cases, skin lesion biopsies were performed. Associations between adverse cutaneous events and clinical, demographic and epidemiological variables were determined using the chi-square test, and logistic regression analyses were performed to identify risk factors. The significance level was set at p<0.05. RESULTS: After 60 months of follow-up, 71 adverse events (73.85/1000 patient-years) were observed, of which allergic and immune-mediated phenomena were the most frequent events, followed by infectious conditions involving bacterial (47.1%), parasitic (23.5%), fungal (20.6%) and viral (8.8%) agents. CONCLUSION: The skin is significantly affected by adverse reactions resulting from the use of TNF-α blockers, and the main risk factors for cutaneous events were advanced age, female sex, a diagnosis of rheumatoid arthritis, disease activity and the use of infliximab. .


Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Anticorps monoclonaux/effets indésirables , Antirhumatismaux/effets indésirables , Arthrite/traitement médicamenteux , Maladies de la peau/induit chimiquement , Facteur de nécrose tumorale alpha/antagonistes et inhibiteurs , Facteurs âges , Arthrite psoriasique/traitement médicamenteux , Maladie chronique , Études de suivi , Études prospectives , Facteurs de risque , Indice de gravité de la maladie , Facteurs sexuels , Statistique non paramétrique , Enquêtes et questionnaires , Peau/effets des médicaments et des substances chimiques , Pelvispondylite rhumatismale/traitement médicamenteux , Facteurs temps , Résultat thérapeutique
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