A Neurologist's Guide to Safe Use of Immunomodulatory Therapies

作者：Vodopivec Ivana^*; Miloslavsky Eli M; Kotton Camille N; Cho Tracey A

来源：Seminars in Neurology, 2014, 34(4): 467-478.

DOI：10.1055/s-0034-1390395

• immunosuppressive drugs
• intravenous immunoglobulin
• safety
• infection
• vaccination
• glucocorticoid-induced osteoporosis
• infertility
• malignancy

Increased understanding of the pathogenesis of immune-mediated neurologic conditions with concomitant development of new therapeutic agents modulating various aspects of the immune system has resulted in the use of innovative therapies in the treatment of these diseases. These novel immunomodulatory therapeutic regimens also augment the potential for complications, including severe adverse effects.
In this review, the authors address practical issues regarding management of patients with neuroimmunological conditions treated with immunomodulatory therapies, including glucocorticoids, methotrexate, azathioprine, mycophenolate, cyclophosphamide, rituximab, tumor necrosis factor-a inhibitors, and intravenous immunoglobulins. Particular focus is placed on their infectious and noninfectious adverse effects, contra-indications, safety monitoring, risk surveillance, and preventive strategies in clinical practice.

• 出版日期2014-9