Risk of complications from specific classes of drugs for inflammatory bowel diseases (IBDs) can be kept low by respecting contraindications. Patients with IBD frequently develop serious infections resulting from the disease itself or its treatment. At the time of diagnosis, patients' vaccination calendars should be updated according to IBD guidelines-live vaccines should be postponed for patients receiving immunosuppressive drugs. Opportunistic infections should be detected and the vaccine against pneumococcus should be given before patients begin immunosuppressive therapy. Thiopurines promote serious viral infections in particular, whereas tumor necrosis factor (TNF) antagonists promote all types of serious and opportunistic infections. Severe forms of varicella can be prevented by vaccinating seronegative patients against varicella zoster virus. Detection and treatment of latent tuberculosis is mandatory before starting anti-TNF therapy and other new IBD drugs. Tofacitinib promotes herpes zoster infection in a dose- and age-dependent manner. Physicians should consider giving patients live vaccines against herpes zoster before they begin immunosuppressive therapy or a recombinant vaccine, when available, at any time point during treatment. The risk of thiopurine-induced lymphomas can be lowered by limiting the use of thiopurines in patients who are seronegative for Epstein-Barr virus (especially young men) and in older men. The risk of lymphoma related to monotherapy with anti-TNF agents is still unclear. There are no robust data on the carcinogenic effects of recently developed IBD drugs. For patients with previous cancer at substantial risk of recurrence, physicians should try to implement a pause in the use of immunosuppressive therapy (except in patients with severe disease and no therapeutic alternative) and prioritize use of IBD drugs with the lowest carcinogenic effects. Finally, sun protection and skin surveillance from the time of diagnosis are recommended.

中文翻译：

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预测，预防和管理炎症性肠病患者的治疗相关并发症。

通过遵守禁忌症，可以降低特定类别的炎症性肠病（IBDs）药物引起并发症的风险。IBD患者经常因疾病本身或其治疗而导致严重感染。诊断时，应根据IBD指南更新患者的疫苗接种日历；对于接受免疫抑制药物的患者，应推迟使用活疫苗。在患者开始免疫抑制治疗之前，应检测机会性感染并应接种抗肺炎球菌疫苗。硫嘌呤尤其促进严重的病毒感染，而肿瘤坏死因子（TNF）拮抗剂则促进所有类型的严重和机会感染。可以通过给血清阴性患者接种水痘带状疱疹病毒疫苗来预防严重形式的水痘。在开始抗TNF治疗和其他新的IBD药物治疗之前，必须对潜伏性结核病进行检测和治疗。托法替尼以剂量和年龄依赖性方式促进带状疱疹感染。在开始免疫抑制治疗之前，医师应考虑为患者提供带状疱疹的活疫苗或在治疗过程中的任何时间点提供重组疫苗（如果有）。通过限制对爱泼斯坦-巴尔病毒呈阴性反应的患者（尤其是年轻男性）和老年男性使用硫嘌呤，可以降低由硫嘌呤引起的淋巴瘤的风险。与抗TNF药物单一治疗相关的淋巴瘤的风险尚不清楚。没有关于最新开发的IBD药物致癌作用的可靠数据。对于先前有严重复发风险的癌症患者，医生应尝试暂停使用免疫抑制疗法（除非患有严重疾病且无其他治疗选择），并优先使用具有最低致癌作用的IBD药物。最后，建议从诊断开始就进行防晒和皮肤监视。