Povezanost biološke terapije i malignih bolesti u upalnim reumatskim bolestima

master's thesis

• Title (english): The association between biological therapy and malignancies in rheumatic diseases
• Author: Martina Jambrović
• Mentor: Mislav Cerovec (mentor)
• Committee member: Branimir Anić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Mislav Cerovec (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Biološki lijekovi su nova generacija protuupalnih lijekova koji se, između ostalog, koriste i u liječenju sistemskih upalnih reumatskih bolesti. Oni djeluju na način da interferiraju sa imunološkim sustavom, najčešće na razini proupalnih citokina, odnosno citokinskih receptora. Iako je učinkovitost bioloških lijekova u liječenju upalnih reumatskih bolesti dobra, potreban je oprez zbog mogućih nuspojava – primjerice razvoja maligne bolesti. Provedena su brojna epidemiološka istraživanja s ciljem da se utvrdi koji su rizici za obolijevanje od maligne bolesti kod osoba oboljelih od upalnih reumatskih bolesti koji su liječeni biološkom terapijom. Podaci za studije su najčešće dobivani iz nacionalnih registara reumatskih bolesti, odnosno registara bolesnika liječenih biološkom terapijom. Rezultati provedenih istraživanja se razlikuju, neke studije govore u prilog povišenog rizika za razvoj malignih bolesti, dok neke ističu da rizik nije povišen u odnosu na rizik koji proizlazi iz same bolesti ili u odnosu na rizik u općoj populaciji. Rezultate treba uzeti s oprezom, jer su mnoga istraživanja ograničena već samim odabirom ispitanika koji često nije reprezentativan ili se u studijama pojavljuje sistemska greška koja dovodi do pogrešnih rezultata. U ovom radu su prikazane studije koje su proučavale koliki je ukupni povišeni rizik za razvoj karcinoma bilo kojeg sijela, rizik od pojave malignih hematoloških bolesti, solidnih i kožnih tumora, melanoma te rizik pojave novog malignoma kod osoba sa ranije dijagnosticiranim malignim tumorom (prije uvođenja biološke terapije). Zbog sve veće primjene i brzog razvoja novih bioloških lijekova svakako je opravdan velik broj istraživanja koja se bave sigurnošću primjene tih lijekova.

Abstract (english)

Biologics are a new generation of anti-inflammatory drugs which are used in the treatment of systemic inflammatory rheumatic diseases. They interfere with immunologic system, mostly on proinflammatory cytokine level. Although their efficiency is very effective, they can cause some very serious side effects as malignancy. Many epidemiological studies are conducted in order to determine the risk of developing malignant disease in people with inflammatory rheumatic disease receiving biological therapy. Data for the study were mostly received individually from the national register of rheumatic diseases. The results of the study are twofold, some studies suggest a higher risk for the development of malignancies, and while others point out that the risk was not increased in relation to the risk arising from the disease itself or in the relation to the risk in the general population observed. The results should be taken with caution, because many studies are limited just by selecting subjects that are often not representative, or a system error occurs which leads to wrong results. This paper provides an overview of studies, looking at how increased is the overall risk of developing cancer of any sites, the risk of malignant hematological diseases, solid and skin tumors, melanoma, and the risk of new tumors in patients with previous diagnosis of cancer. Due to increasing administration and a rapid development of new drugs, a number of studies dealing with the safety medications is certainly justified.

• Keywords: biološka terapija; maligne bolesti; upalne reumatske bolesti
• Keywords (english): biologics; malignancy; inflammatory rheumatic diseases
• Language: croatian
• URN:NBN: urn:nbn:hr:105:272535
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-13 08:54:38