| 日 | 月 | 火 | 水 | 木 | 金 | 土 |
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| 6 | 7 | 8 | 9 | 10 | 11 | 12 |
| 13 | 14 | 15 | 16 | 17 | 18 | 19 |
| 20 | 21 | 22 | 23 | 24 | 25 | 26 |
| 27 | 28 | 29 | 30 | 31 |
◎ Club Rhumatismes et Inflammation (CRI：フランス)：Joint Bone Spine 72 (2005) (Suppl), pp. 49–50
通常の虫歯治療やインプラント導入状態では、必ずしもTNF阻害療法の休薬や中止は必要ないかもしれない。抜歯など感染の可能性のある処置では、休薬と抗生剤投与が薦められる。
[Usual care (caries, scaling)]
There are no data justifying discontinuation of anti-TNFa. therapy, but prophylactic antibiotics may be considered. [Dental care with a risk of infection (extraction, apical granuloma, abscess, etc.)]
Discontinuation of anti-TNFw. therapy is recommended and prophylactic antibiotics should be proposed.
[ Implants]
There is no definite indication to discontinue anti-TNFa therapy, but caution should be exercised with regard to the potential risks of infection.
○ www.australianprescriber.com/magazine/29/3/67/70/
"Minor surgery such as dental procedures does not require cessation of therapy."
? http://www.bad.org.uk/public/leaflets/etanercept.asp (British association of dermatologists)
I am planning to have an operation / dental surgery – what should I do?
Etanercept may increase your risk of getting an infection after a surgical procedure. You must tell the doctor or dentist that you are taking etanercept.
× Treatment with infliximab: Implications in oral surgery? A case report. British Journal of Oral and Maxillofacial Surgery
Volume 45, Issue 6, September 2007, Pages 507-510（英国）. レミケード使用中の外科的なextractionでmandibular osteomyelitisをきたした一例. ただし、mandibular osteomyelitisは抜歯後（抗生剤前投与やステロイドカバーをしている：under local anaesthesia and prophylactic amoxicillin 3 g orally 1 h preoperatively and hydrocortisone 50 mg intramuscularly）すぐに生じたわけではないので、著者らは抜歯の影響は少なく、レミケードのadverse eventであると考えている。
△ http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a602013.htmlでは、外科手術（歯科を含む）では担当医にエンブレルを使っていることを申告するようにと患者アドバイスを記載している。
