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Authors
Abstract(s)
As terapêuticas biológicas surgiram como um complemento aos fármacos
antirreumáticos modificadores de doença, tendo uma implementação alargada pela
comunidade médica dados os seus favoráveis perfis de eficácia e segurança, uma boa
tolerância pelos doentes e uma específica interação entre fármaco e alvo imunológico.
Consistem num grupo bastante diversificado de fármacos que atuam diretamente no
sistema imunológico.
O tratamento das doenças autoimunes na reumatologia apresenta como principal
objetivo a remissão da doença e a prevenção de dano estrutural irreversível. As
terapêuticas biológicas revolucionaram o prognóstico das doenças autoimunes, uma
vez que conseguem reduzir para níveis mínimos o grau de inflamação e da resposta
imune. No entanto, com a implementação crescente destes fármacos na prática médica
surgiram algumas preocupações no que concerne a alguns efeitos adversos.
Tendo em conta que este tratamento condiciona uma supressão imunológica, é de
esperar que se verifique um aumento da suscetibilidade a infeções. Previamente à
instauração desta terapêutica devem ser cumpridos alguns procedimentos de segurança
de forma a minimizar estas consequências indesejadas. No momento da prescrição da
terapêutica, o médico deve realizar uma avaliação objetiva da atividade da doença,
considerando a globalidade dos riscos e benefícios que poderão afetar o doente.
Atualmente o desenvolvimento de estudos que complementem esta área do
conhecimento científico, no que concerne à avaliação de riscos, estratégias de vacinação
e vigilância adequada, é essencial. Para tal, criou-se esta revisão bibliográfica como
apoio científico, que permita clarificar as preocupações decorrentes da implementação
da terapêutica biológica nesta área da medicina, obtendo-se assim, uma fonte de
informação organizada e sistematizada.
Biological therapies have emerged as a complement to disease-modifying antirheumatic drugs, with an extensive implementation by the medical community, given their favorable efficacy and safety profiles, a good tolerance by patients and a specific interaction between drug and immunological target. They consist of a very diverse group of drugs that act directly on the immune system. Treatment of autoimmune diseases in rheumatology has as main objective the remission of disease and prevention of irreversible structural damage. Biological therapies have revolutionized prognosis of autoimmune diseases, since they manage to reduce the degree of inflammation and immune response to minimum levels. However, due to the increasing in implementation of these drugs in medical practice, some concerns have arisen regarding some adverse effects. Bearing in mind that this treatment conditions an immune suppression, it is expected that there will be an increased susceptibility to infections. Prior to establishment of this therapy, some safety procedures must be followed in order to minimize these unintended consequences. At the time of prescribing therapy, physician must carry out an objective assessment of the disease activity, considering overall risk and benefits that may affect the patient. Currently, development of studies which complement this area of scientific knowledge, with regard to risk assessment, vaccination strategies and adequate surveillance, is essential. To this end, this literature review was created as a scientific support to elucidate concerns arising from the implementation of biological therapy in this area of medicine, thus obtaining an organized and systematized source of information.
Biological therapies have emerged as a complement to disease-modifying antirheumatic drugs, with an extensive implementation by the medical community, given their favorable efficacy and safety profiles, a good tolerance by patients and a specific interaction between drug and immunological target. They consist of a very diverse group of drugs that act directly on the immune system. Treatment of autoimmune diseases in rheumatology has as main objective the remission of disease and prevention of irreversible structural damage. Biological therapies have revolutionized prognosis of autoimmune diseases, since they manage to reduce the degree of inflammation and immune response to minimum levels. However, due to the increasing in implementation of these drugs in medical practice, some concerns have arisen regarding some adverse effects. Bearing in mind that this treatment conditions an immune suppression, it is expected that there will be an increased susceptibility to infections. Prior to establishment of this therapy, some safety procedures must be followed in order to minimize these unintended consequences. At the time of prescribing therapy, physician must carry out an objective assessment of the disease activity, considering overall risk and benefits that may affect the patient. Currently, development of studies which complement this area of scientific knowledge, with regard to risk assessment, vaccination strategies and adequate surveillance, is essential. To this end, this literature review was created as a scientific support to elucidate concerns arising from the implementation of biological therapy in this area of medicine, thus obtaining an organized and systematized source of information.
Description
Keywords
Doenças Autoimunes Imunossupressão Infeções Reumatologia Terapêutica Biológica