| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1 MB | Adobe PDF |
Authors
Abstract(s)
Introdução: A artrite reumatóide, espondilite anquilosante e a artrite psoriática são
doenças do foro reumatológico, cujo tratamento pode passar pelo uso de agentes
biológicos como os pertencentes à classe dos inibidores do fator de necrose tumoral
alfa. Estes apresentam como efeito secundário a imunossupressão pelo que o seu uso
em doentes com história de doença oncológica é debatido e atualmente evitado por
receio de recidiva. No entanto, na literatura, não está descrito aumento de risco de
recorrência de neoplasia nem agravamento da mesma decorrente do uso destes
fármacos.
Materiais e métodos: Estudo retrospetivo dos registos clínicos dos pacientes
seguidos por doença reumatológica expostos a agentes biológicos no Hospital Amato
Lusitano, num total de 111 doentes, dos quais 11 desenvolveram neoplasia durante
tratamento com terapêutica biológica.
Resultados: Dos 111 pacientes estudados, a maioria padecia de artrite reumatóide
(48,6%) e estava sob tratamento com agentes pertencentes à classe dos inibidores do
fator de necrose tumoral alfa (76,6%) e algum tipo de tratamento adjuvante (72,9%).
Apenas 9,9% dos pacientes desenvolveu cancro durante o tratamento.
Discussão: A contribuição dos agentes inibidores do fator de necrose tumoral alfa
para o risco de desenvolvimento de cancro não é clara, mas estudos anteriores referem
não existir diferenças significativas nos doentes a elas submetidos, algo corroborado
pelo presente trabalho, com apenas 9,9% dos pacientes sob este tratamento a
desenvolver cancro. O tipo de cancro que os 11 doentes desenvolveram ao longo do
tratamento foi muito heterogéneo e o seu estadiamento TNM foi muito disperso.
Apenas 1 doente morreu e a maioria dos doentes suspendeu o tratamento com agentes
biológicos e nenhum retomou.
Conclusão: A presente dissertação não evidenciou um aumento da ocorrência de
neoplasias derivados do uso de agentes biológicos.
Introduction: Rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis are rheumatologic diseases whose treatment may involve the use of biological agents, such as tumor necrosis factor alpha inhibitors. These medications have immunosuppression as a side effect, raising concerns about their use in patients with a history of cancer, and currently avoided due to fear of recurrence. However, previous literature does not describe an increased risk of cancer recurrence or worsening due to the use of these drugs. Materials and methods: A retrospective study of clinical records of patients with rheumatologic diseases treated with biological agents at Amato Lusitano Hospital, totaling 111 patients, of whom 11 developed neoplasms during biological therapy. Results: Of the 111 patients studied, the majority had rheumatoid arthritis (48.6%) and were undergoing treatment with tumor necrosis factor alpha inhibitors (76.6%), as well as some form of combined treatment (72.9%). Only 9.9% of patients developed cancer during treatment. Discussion: The contribution of tumor necrosis factor alpha inhibitors to cancer risk is not clear, but previous studies have found no significant differences in patients undergoing such treatment, as corroborated by this study, with only 9.9% of patients in treatment developing cancer. The type of cancer that the 11 patients developed during treatment was highly diverse, and their TNM staging was scattered. Only one patient died, and the majority discontinued biological agent treatment, with none resuming. Conclusion: This study did not show an increase in the incidence of neoplasms associated with the use of biological agents.
Introduction: Rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis are rheumatologic diseases whose treatment may involve the use of biological agents, such as tumor necrosis factor alpha inhibitors. These medications have immunosuppression as a side effect, raising concerns about their use in patients with a history of cancer, and currently avoided due to fear of recurrence. However, previous literature does not describe an increased risk of cancer recurrence or worsening due to the use of these drugs. Materials and methods: A retrospective study of clinical records of patients with rheumatologic diseases treated with biological agents at Amato Lusitano Hospital, totaling 111 patients, of whom 11 developed neoplasms during biological therapy. Results: Of the 111 patients studied, the majority had rheumatoid arthritis (48.6%) and were undergoing treatment with tumor necrosis factor alpha inhibitors (76.6%), as well as some form of combined treatment (72.9%). Only 9.9% of patients developed cancer during treatment. Discussion: The contribution of tumor necrosis factor alpha inhibitors to cancer risk is not clear, but previous studies have found no significant differences in patients undergoing such treatment, as corroborated by this study, with only 9.9% of patients in treatment developing cancer. The type of cancer that the 11 patients developed during treatment was highly diverse, and their TNM staging was scattered. Only one patient died, and the majority discontinued biological agent treatment, with none resuming. Conclusion: This study did not show an increase in the incidence of neoplasms associated with the use of biological agents.
Description
Keywords
Agentes Biológicos Artrite Psoriática Artrite Reumatóide Cancro Espondilite Anquilosante Itnf Neoplasia