Article information
Resumen
Los tratamientos biológicos para la psoriasis, principalmente los inhibidores del factor de necrosis tumoral alfa (TNF-α), han demostrado su eficacia y seguridad desde los ensayos clínicos hasta su posterior comercialización. Sin embargo, los estudios de farmacovigilancia han detectado un ligero incremento de las infecciones.
El manejo del riesgo infeccioso en los pacientes con psoriasis en tratamiento con etanercept u otros medicamentos anti-TNF pasa por valorar la idoneidad de su uso en aquellos pacientes con infecciones por los virus de la hepatitis C, B y de la inmunodeficiencia humana, con infecciones activas localizadas o generalizadas, con riesgo de sepsis (portadores de catéteres endovenosos y sondas urinarias permanentes) o con trastornos subyacentes que pudieran predisponer a sufrir infecciones (diabetes, hemodiálisis). En caso de que un paciente en tratamiento con etanercept presente una infección, si ésta es grave debe suspenderse el tratamiento y si es leve deberá seguirse estrechamente al paciente, y la interrupción del tratamiento se decidirá en función de su evolución.
La larga experiencia de uso de etanercept en diferentes enfermedades permite afirmar que tiene un buen perfil de seguridad en lo que se refiere a las infecciones, si se toman las precauciones referentes a la tuberculosis y a la concomitancia de otras infecciones activas durante el tratamiento.
Palabras clave:
Etanercept
Infecciones
Infecciones cutáneas
Pitiriasis versicolor
Conjuntivitis
Abstract
The biological treatments for psoriasis, mainly the tumor necrosis factor-alpha inhibitors (TNF-α), have demonstrated their efficacy and safety beginning with the clinical trials up to their subsequent marketing. However, pharmacovigilance studies have detected a mild increase in infections.
For the management of infectious risk in patients with psoriasis being treated with etanercept or other anti-TNF medications, an evaluation should be made of the adequacy of its use in patients infected by HCV, HBV, HIV, with localized or generalized infections, with risk of sepsis (carriers of intravenous catheter and indwelling urinary catheter) or with underlying disorders that could predispose them to infections (diabetes, hemodialysis). If a patient under treatment with etanercept presents an infection, if the infection is serious, treatment should be discontinued and if it is mild, the patient should be closely monitored and treatment interrupted if decided based on the evolution.
Long experience on the use of etanercept in different diseases has made it possible to state that it has a good safety profile in regards to infections, if precautions are taken in regards to tuberculosis and the concomitance of other active infections during the treatment.
Keywords:
Etanercept
Infection
Skin infections
Pityriasis versicolor
Conjunctivitis
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