15 let zkušeností s biologickou léčbou zánětlivých revmatických onemocnění v národním registru ATTRA

Title in English 15 years' experience with biological therapy of inflammatory rheumatic diseases in Czech national register ATTRA

PAVELKA Karel ŠEDOVÁ Liliana HEJDUK Karel DUŠEK Ladislav

Year of publication 2016
Type Article in Periodical
Magazine / Source Časopis lékařů českých
MU Faculty or unit

Faculty of Medicine

Field Other medical specializations
Keywords biological therapy; registry; inflammatory rheumatic diseases
Description The publicat on is summarizing application of biological DMARDs in autoimmune infiaTimatory rheumatic diseases. Up to now conventional therapy, which for example in rheumatoid arthritis was application of methotrexate (Mix) in combination with glucocorticoids, was effective, but the rem'ssion as a target was achieved in small oroportion of patients and also there was little effect on structural progression of d seases. Biological therapy was great advance because response was achieved in % patients who failed MTx. At present time 8 biological drugs are available. 5 are inhibitors of TNFa and 3 have different move of action. In psoriatic arthritis are beside TNF blockers available blocker of IL17 (secukinumab, ustekinumab, aoremilast). For ankylos ng spondylitis is registered secukinumab. Anti-TNF therapy is relative safe but rarely serious adverse events can occur. The most important are serious infections, opportunistic infections and tuberculosis. Other adverse event 'ncludes allergic reactions and local intolerance. Increase incidence of lymphomas was not confirmed. There is probably minimal increased risk of skin melanoma and non-melanoma tumors. Benefit/risk ratio is stll very positive. National registry of biological therapy ATTRA was founded 15 years ago and includes patients with rheumatoid arthrit s, ankylos-ing spordylitis, psoriatic arthrit s and juvenile idiopathic arthritis. In June 2016 over all 6800 patients with those diagnoses was included and actually 5194 have been treated. In registry patients are regularly followed for activity, efficacy of the drug and other events. Results of registry are sent payers for evaluations o* phar-macologic parameters.

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