臨床整形外科50巻2号

2015年02月発行

誌上シンポジウム 関節リウマチ—生物学的製剤使用で変化したこと

局所感染・創傷治癒の変化

著者： 宮原寿明¹

所属機関： ¹九州医療センターリウマチ・膠原病センター

ページ範囲：P.113 - P.118

　関節リウマチ(RA)治療に生物学的製剤が広く使用されるようになった現在，整形外科手術後の手術部位感染と創傷治癒遅延に対する対策が必要である．生物学的製剤投与RA患者の整形外科手術における手術部位感染発生率は0〜20％であり，非投与RA患者の発生率と比較して，同等か軽度上昇すると推測される．特に人工関節置換術での感染率上昇の可能性が高く，注意を要する．基礎研究では生物学的製剤の創傷治癒遅延作用が示されているが，臨床的エビデンスは不十分である．トシリズマブについては創傷治癒遅延がやや高率に発生した報告があり，注意を要する．

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