[Adverse effects of biological therapy in rheumatology].

UNLABELLED: The biological treatment which is the most effective type of therapy for inflammatory rheumatic diseases, has become part of a standard clinical rheumatology practice in recent years. Thousands of patients in the Czech Republic with rheumatoid arthritis, different forms of spondyloarthritides and with psoriatic arthritis are now successfully treated in this way. The following medications are registered in the Czech Republic for the treatment of rheumatic diseases: infliximab, adalimumab, golimumab, certolizumab pegol, etanercept, abatacept, rituximab, tocilizumab and belimumab, newly also secukinumab. This effective therapy also entails a new spectrum of adverse effects, different to those of the synthetic disease modifying antirheumatic drugs. The most frequent problems include a higher incidence of infections including exacerbation of latent tuberculosis, further we can meet hematological, gastroenterological and immunological abnormalities some of which, luckily of rare occurrence, may have a very serious character. The cardiovascular risk is rather reduced during long-term therapy, however in patients with chronic heart failure the anti-TNF therapy may lead to its worsening. All physicians caring for patients with inflammatory rheumatic diseases should have the basic knowledge of the range of the adverse effects.

KEY WORDS: abatacept - adalimumab - ankylosing spondylitis - biological treatment - certolizumab pegol - goli-mumab - TNFα inhibitors - infliximab - adverse effects - psoriatic arthritis - rheumatoid arthritis - rituximab - secukinumab - tocilizumab.