RESUMEN
Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC), both chronic, relapsing, incurable conditions. Phenotypical expression may vary, and a fraction of patients respond appropriately to conventional drugs without complications or need for hospitalization. At the opposite end of this spectrum, 30-40% of patients have severe, aggressive disease poorly responsive to conventional drugs. These latter patients urgently need more advanced therapy options, which also represent additional safety concerns. IBD management has become increasingly complex, and specialist care is deemed associated with better outcomes in the management of patients with IBD.
Asunto(s)
Gastroenterología , Enfermedades Inflamatorias del Intestino/terapia , Humanos , Enfermedades Inflamatorias del Intestino/epidemiología , España/epidemiología , EspecializaciónRESUMEN
El riesgo de enfermar de tuberculosis ha aumentado en los pacientes con enfermedades inflamatorias crónicas que reciben tratamiento inmunosupresor, en particular en aquellos tratados con terapia anti-TNF (del inglés tumor necrosis factor). En estos pacientes es obligatoria la detección de la infección tuberculosa latente y el tratamiento de dicha infección, dirigido a reducir el riesgo de progresión a enfermedad tuberculosa. Este documento de consenso resume la opinión de expertos y los conocimientos actuales sobre tratamientos biológicos, incluidos los bloqueantes del TNF. Se establecen recomendaciones para la utilización de las técnicas de liberación de interferón-gamma (IGRA) y la prueba de la tuberculina (PT) para el diagnóstico y el tratamiento de la infección tuberculosa latent
Tuberculosis risk is increased in patients with chronic inflammatory diseases receiving any immunosuppressive treatment, notably tumor necrosis factor (TNF) antagonists therapy. Screening for the presence of latent infection with Mycobacterium tuberculosis and targeted preventive treatment to reduce the risk of progression to TB is mandatory in these patients. This Consensus Document summarizes the current knowledge and expert opinion of biologic therapies including TNF-blocking treatments. It provides recommendations for the use of interferon-gamma release assays (IGRA) and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in these patients, and for the type and duration of preventive therapy
Asunto(s)
Humanos , Masculino , Femenino , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Tuberculosis/terapia , Conferencias de Consenso como Asunto , Terapia Biológica/métodos , Terapia Biológica , Tuberculosis Latente/prevención & control , Ensayos de Liberación de Interferón gamma/métodos , Terapia Biológica/normas , Terapia Biológica/tendencias , Tuberculosis Latente/terapia , Ensayos de Liberación de Interferón gamma/normas , Ensayos de Liberación de Interferón gamma , Enfermedad Crónica/prevención & controlRESUMEN
Tuberculosis risk is increased in patients with chronic inflammatory diseases receiving any immunosuppressive treatment, notably tumor necrosis factor (TNF) antagonists therapy. Screening for the presence of latent infection with Mycobacterium tuberculosis and targeted preventive treatment to reduce the risk of progression to TB is mandatory in these patients. This Consensus Document summarizes the current knowledge and expert opinion of biologic therapies including TNF-blocking treatments. It provides recommendations for the use of interferon-gamma release assays (IGRA) and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in these patients, and for the type and duration of preventive therapy.
Asunto(s)
Terapia Biológica , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/terapia , Humanos , Terapia de Inmunosupresión , Tuberculosis Latente/prevención & control , Guías de Práctica Clínica como AsuntoRESUMEN
No disponible
