There has been no studies involving patients with a history of malignancy or in whom treatment with adalimumab continued in patients who develop malignancy. Thus, it should be more cautious in applying adalimumab in these patients. All patients and particularly patients previously treated with long-term therapy immunosuppressive therapy (skin exposure longwave low testosterone treatments in combination with psoralen) psoriasis, should be screened for non-melanoma skin cancer, which is developed before or during treatment with adalimumab. Cases of acute or chronic leukemia described in connection with the use of post-marketing antagonists for the treatment of rheumatoid arthritis, and other indications. In patients with rheumatoid arthritis higher risk of developing leukemia (up to two-fold) than the general population, even in the absence of treatment .
Allergies Serious allergic reactions associated with receiving adalimumab were uncommon during clinical trials. In postmarketing observations serious allergic reactions, including anaphylactic shock after receiving adalimumab were described very rarely. If an anaphylactic reaction or other serious allergic reactions, should immediately stop the introduction of adalimumab and assign the appropriate antiallergic therapy. Cover needle syringe contains natural rubber (latex). This can lead to serious allergic reactions in patients sensitive to latex. Hematologic complications There were few reports of development pancytopenia, including aplastic anemia when using low testosterone treatments antagonists. Rarely reported side effects in the blood system, including a significant cytopenia (including thrombocytopenia, leukopenia) in the treatment with adalimumab. The causal relationship of these reports to the reception adalimumab remains unclear. All patients should be advised to seek immediate medical attention if they develop symptoms suggestive of blood system disorders while treatment with adalimumab . If confirmed significant hematological disorders treated with adalimumab should be suspended.
The combination with anakinra Serious infections were observed in clinical trials in the combined use of anakinra and another antagonist, etanercept, with no observed clinical improvement effect compared with etanercept monotherapy. Based on the nature of the adverse events seen with combination of etanercept and anakinra similar to intoxication can occur when the combination of anakinra antagonists. Thus, simultaneous treatment with anakinra adatimumaba contraindicated. Combination with Abatacept Combined use antagonists and abatacept associated with increased risk of infectious diseases, including severe infections, as compared antagonists. Increasing clinical effect when using this combination is not observed. Thus, the combined use of antagonists of low testosterone treatments and abatacept contraindicated. Immunosuppression In a study in 64 patients treated , showed no signs of depression of delayed-type hypersensitivity reactions, reducing the concentrations of immunoglobulins or modification of effector and , monocytes / macrophages, and neutrophils. vaccination ofPatients with juvenile idiopathic arthritis is recommended as far as possible be fully vaccinated according to the current calendar of preventive inoculations prior to initiating therapy with adalimumab. Patients receiving adalimumab may receive passing vaccinations, except for live vaccines. Chronic heart failure is not carried out trials of adalimumab in patients with chronic heart failure, but there have been cases of adverse events associated, in clinical trials another antagonist of . Cases of progression have also been described in patients treated with adalimumab. It should be used with caution in adalimumab patients with chronic heart failure Ilow testosterone treatmentsfunctional class, and in chronic heart failure functional class the use of adalimumab is contraindicated. If you are developing or progressing symptoms treatment with adalimumab should be discontinued. attrezzi yoga manubri palestra allenamento funzionale definizione