{"id":6872,"date":"2023-08-21T06:27:00","date_gmt":"2023-08-21T09:27:00","guid":{"rendered":"https:\/\/gastropedia.pub\/pt\/?p=6872"},"modified":"2023-08-22T11:37:36","modified_gmt":"2023-08-22T14:37:36","slug":"check-list-para-iniciar-terapia-biologica-na-dii","status":"publish","type":"post","link":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/","title":{"rendered":"Check-list para iniciar terapia biol\u00f3gica na DII"},"content":{"rendered":"<div class=\"pdfprnt-buttons pdfprnt-buttons-post pdfprnt-top-right\"><a href=\"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/6872?print=pdf\" class=\"pdfprnt-button pdfprnt-button-pdf\" target=\"_blank\" ><img decoding=\"async\" src=\"https:\/\/gastropedia.pub\/pt\/wp-content\/plugins\/pdf-print\/images\/pdf.png\" alt=\"image_pdf\" title=\"Ver PDF\" \/><\/a><a href=\"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/6872?print=print\" class=\"pdfprnt-button pdfprnt-button-print\" target=\"_blank\" ><img decoding=\"async\" src=\"https:\/\/gastropedia.pub\/pt\/wp-content\/plugins\/pdf-print\/images\/print.png\" alt=\"image_print\" title=\"Conte\u00fado de impress\u00e3o\" \/><\/a><\/div>\n<p>Os pacientes com fen\u00f3tipo de <strong>DII <\/strong>(Doen\u00e7a Inflamat\u00f3ria Intestinal) <strong>moderada a grave<\/strong> e\/ou com fatores de risco para pior progn\u00f3stico, uma vez eleitos para <strong>terapia avan\u00e7ada com biol\u00f3gicos<\/strong>, devem passar por uma prepara\u00e7\u00e3o para o in\u00edcio do tratamento com seguran\u00e7a.<\/p>\n\n\n\n<p class=\"has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background\"><strong>Essa etapa passa pela avalia\u00e7\u00e3o de 3 pilares:<\/strong><\/p>\n\n\n\n<ul class=\"has-very-light-gray-to-cyan-bluish-gray-gradient-background has-background wp-block-list\">\n<li>Checar se h\u00e1 contraindica\u00e7\u00e3o relativa ou absoluta ao uso de tais medicamentos;<\/li>\n\n\n\n<li>Rastreio de infec\u00e7\u00f5es ativas ou latentes;<\/li>\n\n\n\n<li>Atualiza\u00e7\u00e3o de status vacinal<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-no-que-se-refere-as-contraindicacoes-ou-sinais-de-maior-atencao-ao-uso-de-biologicos-temos\"><strong>No que se refere \u00e0s contraindica\u00e7\u00f5es ou sinais de maior aten\u00e7\u00e3o ao uso de biol\u00f3gicos, temos:<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Infec\u00e7\u00e3o grave em curso, inclusive abscesso perianal;<\/li>\n\n\n\n<li>Tuberculose latente n\u00e3o tratada (deve se aguardar um per\u00edodo do in\u00edcio do tratamento para iniciar o biol\u00f3gico, preferencialmente um n\u00e3o anti-TNF);<\/li>\n\n\n\n<li>ICC descompensada ou fra\u00e7\u00e3o de eje\u00e7\u00e3o de VE \u2264 35% (contraindica\u00e7\u00e3o absoluta a anti-TNF);<\/li>\n\n\n\n<li>Hist\u00f3ria de rea\u00e7\u00e3o infusional grave pr\u00e9via a biol\u00f3gicos;<\/li>\n\n\n\n<li>Esclerose m\u00faltiplas ou outras doen\u00e7as desmielinizantes; neurite \u00f3ptica; linfoma pr\u00e9vio (nessas condi\u00e7\u00f5es o anti-TNF tem contraindica\u00e7\u00e3o absoluta, os demais pesar risco x benef\u00edcio);<\/li>\n\n\n\n<li>Malignidade corrente;<\/li>\n\n\n\n<li>Doen\u00e7a hep\u00e1tica descompensada (cirrose Child B ou C);<\/li>\n\n\n\n<li>Infec\u00e7\u00e3o cr\u00f4nica n\u00e3o tratada pelo v\u00edrus da hepatite B;<\/li>\n\n\n\n<li>Infec\u00e7\u00e3o pelo HIV n\u00e3o controlada;<\/li>\n\n\n\n<li>Hist\u00f3ria de melanoma (contraindica\u00e7\u00e3o absoluta a anti-TNF) ou displasia de colo uterino recorrente (contraindica\u00e7\u00e3o relativa a anti-TNF)<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-o-proximo-passo-e-a-realizacao-do-rastreio-infeccioso-que-inclui\"><strong>O pr\u00f3ximo passo \u00e9 a realiza\u00e7\u00e3o do rastreio infeccioso, que inclui:<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Radiografia de t\u00f3rax;<\/li>\n\n\n\n<li>PPD e\/ou IGRA (teste de libera\u00e7\u00e3o de interferon gama);<\/li>\n\n\n\n<li>Sorologias para hepatites B, C e HIV (considerar tamb\u00e9m adicionar rastreio de sarampo, CMV, varicela zoster e Epstein-Barr &#8211; atentar que a infec\u00e7\u00e3o prim\u00e1ria por EBV em paciente imunossuprimidos aumenta risco de doen\u00e7as linfoproliferativas, nesse cen\u00e1rio deve se ter cautela ao prescrever tiopurinas associadas);<\/li>\n\n\n\n<li>Na presen\u00e7a de diarreia, excluir presen\u00e7a de Clostridium difficile como agente mimetizador;<\/li>\n\n\n\n<li>Na popula\u00e7\u00e3o feminina, tamb\u00e9m \u00e9 recomend\u00e1vel colpocitologia para screening de infec\u00e7\u00e3o por HPV.<\/li>\n<\/ul>\n\n\n\n<p>O rastreio de TB latente deve ser renovado anualmente enquanto o paciente estiver em uso do biol\u00f3gico, especialmente se for da classe anti-TNF, pois sabemos o quanto o TNF-alfa \u00e9 primordial para a estabilidade do granuloma.<\/p>\n\n\n\n<p>Em caso de pacientes com PPD \u2265 5mm, ou IGRA + ou sequelas na radiografia de t\u00f3rax sugestivas, primeiro deve-se iniciar o tratamento da TB latente e somente iniciar o biol\u00f3gico ap\u00f3s 30 dias do come\u00e7o do tratamento.<\/p>\n\n\n\n<p>Pacientes com HBsAg + ou com anti-HBc + isolado devem receber terapia antiviral durante o uso de biol\u00f3gicos ou imunossupressores orais. No primeiro caso, o tempo de tratamento ser\u00e1 guiado pela doen\u00e7a hep\u00e1tica. No segundo caso (infec\u00e7\u00e3o oculta), por pelo menos 6 meses ap\u00f3s o t\u00e9rmino do tratamento (se for o caso).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-status-vacinal\"><strong>Status vacinal<\/strong><\/h2>\n\n\n\n<p>Em se tratando de esquema vacinal, as vacinas inativadas s\u00e3o extremamente seguras e indicadas para todos os pacientes com DII, e idealmente devem ser administradas pelo menos 2 semanas antes do biol\u00f3gico, para n\u00e3o comprometer a resposta vacinal. J\u00e1 as <strong>vacinas atenuadas s\u00e3o<\/strong> <strong>contraindicadas<\/strong> aos paciente que j\u00e1 est\u00e3o em uso de imunossupressores ou biol\u00f3gicos, ou que est\u00e3o planejando iniciar tais medica\u00e7\u00f5es nas pr\u00f3ximas 4 a 6 semanas. Somente poder\u00e3o usar vacinas atenuadas ap\u00f3s 3 meses de suspens\u00e3o de tais medica\u00e7\u00f5es (se for o caso).<\/p>\n\n\n\n<p>As vacinas inativadas a serem consideradas em pacientes com DII s\u00e3o: Influenza, Pneumoc\u00f3cica, T\u00e9tano\/Difteria (Dupla Adulta), Meningococo, Hepatite A, Hepatite B (inclusive podendo-se fazer 4 doses dobradas almejando anti-HBs &gt;10), HPV, COVID-19. Recentemente, tamb\u00e9m foi lan\u00e7ada a vacina de herpes-zoster inativada recombinante, possibilitando o uso aos paciente em imunossupress\u00e3o ou em planejamento de iniciar biol\u00f3gicos, diferente da vacina at\u00e9 ent\u00e3o dispon\u00edvel que era de v\u00edrus atenuado.<\/p>\n\n\n\n<p>Refor\u00e7ando, as vacinas atenuadas que <strong>n\u00e3o devem<\/strong> ser feitas no cen\u00e1rio de pacientes imunossuprimidos s\u00e3o: tr\u00edplice viral (sarampo, caxumba e rub\u00e9ola), varicela, febre amarela e a vers\u00e3o mais antiga da vacina de herpes zoster composta de v\u00edrus vivo atenuado.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-referencias\"><strong>Refer\u00eancias:<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>T. Kucharzik et al. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. Journal of Crohn&#8217;s and Colitis, 2021, 879\u2013913<\/li>\n\n\n\n<li>Chebli JMF et al. Preparing Patients With Inflammatory Bowel Diseases For Biological Therapies In Clinical Practice. Journal of Gastroenterology and Hepatology Research 2018; 7(2): 2535-2554<\/li>\n\n\n\n<li>Beaugerie et al. Predicting, Preventing, and Managing Treatment-Related Complications in Patients With Inflammatory Bowel Diseases. Clinical Gastroenterology and Hepatology 2020;18:1324\u20131335<\/li>\n\n\n\n<li>S. Riestra et al. Recommendations of the Spanish Working Group on Crohn\u2019s Disease and Ulcerative Colitis (GETECCU) on screening and treatment of tuberculosis infection in patients with inflammatory bowel disease. Gastroenterolog\u00eda y Hepatolog\u00eda 44 2021 51&#8212;66<\/li>\n\n\n\n<li>R. Ferreiro-Iglesias et al. Recommendations of the Spanish Group on Crohn\u2019s Disease and Ulcerative Colitis on the importance, screening and vaccination in inflammatory bowel disease patients. Gastroenterolog\u00eda y Hepatolog\u00eda 45 (2022) 805&#8212;818<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-como-citar-este-artigo\"><strong>Como citar este artigo<\/strong><\/h2>\n\n\n\n<p class=\"has-background\" style=\"background-color:#dde1e7\">Vilela PBM, Check-list para iniciar terapia biol\u00f3gica na DII Gastropedia 2023, Vol 2. Dispon\u00edvel em: gastropedia.pub\/pt\/sem-categoria\/check-list-para-iniciar-terapia-biologica-na-dii\/<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Os pacientes com fen\u00f3tipo de DII (Doen\u00e7a Inflamat\u00f3ria Intestinal) moderada a grave e\/ou com fatores de risco para pior progn\u00f3stico, uma vez eleitos para terapia avan\u00e7ada com biol\u00f3gicos, devem passar&hellip;<\/p>\n","protected":false},"author":5686,"featured_media":3148,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[18,22],"tags":[],"ano":[137],"tipo":[121],"volume":[44],"class_list":["post-6872","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gastroenterologia","category-intestino","ano-137","tipo-assuntos-gerais","volume-volume-ii"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Check-list para iniciar terapia biol\u00f3gica na DII - Gastropedia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Check-list para iniciar terapia biol\u00f3gica na DII\" \/>\n<meta property=\"og:description\" content=\"Os pacientes com fen\u00f3tipo de DII (Doen\u00e7a Inflamat\u00f3ria Intestinal) moderada a grave e\/ou com fatores de risco para pior progn\u00f3stico, uma vez eleitos para terapia avan\u00e7ada com biol\u00f3gicos, devem passar&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/\" \/>\n<meta property=\"og:site_name\" content=\"Gastropedia\" \/>\n<meta property=\"article:published_time\" content=\"2023-08-21T09:27:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-22T14:37:36+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/imag-alex.jpg?v=1668113710\" \/>\n\t<meta property=\"og:image:width\" content=\"563\" \/>\n\t<meta property=\"og:image:height\" content=\"294\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Patr\u00edcia Barbosa Maur\u00edcio Vilela\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Patr\u00edcia Barbosa Maur\u00edcio Vilela\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/\"},\"author\":{\"name\":\"Patr\u00edcia Barbosa Maur\u00edcio Vilela\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/b0afb748639b8b4900f138923ace3e8e\"},\"headline\":\"Check-list para iniciar terapia biol\u00f3gica na DII\",\"datePublished\":\"2023-08-21T09:27:00+00:00\",\"dateModified\":\"2023-08-22T14:37:36+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/\"},\"wordCount\":869,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/imag-alex.jpg?v=1668113710\",\"articleSection\":[\"Gastroenterologia\",\"Intestino\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/\",\"name\":\"Check-list para iniciar terapia biol\u00f3gica na DII - Gastropedia\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/imag-alex.jpg?v=1668113710\",\"datePublished\":\"2023-08-21T09:27:00+00:00\",\"dateModified\":\"2023-08-22T14:37:36+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/b0afb748639b8b4900f138923ace3e8e\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#primaryimage\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/imag-alex.jpg?v=1668113710\",\"contentUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2022\\\/11\\\/imag-alex.jpg?v=1668113710\",\"width\":563,\"height\":294},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/gastroenterologia\\\/intestino\\\/check-list-para-iniciar-terapia-biologica-na-dii\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"In\u00edcio\",\"item\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Check-list para iniciar terapia biol\u00f3gica na DII\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#website\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/\",\"name\":\"Gastropedia\",\"description\":\"Atualiza\u00e7\u00e3o m\u00e9dica de forma descomplicada para profissionais que trabalham com sa\u00fade do aparelho digestivo.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/#\\\/schema\\\/person\\\/b0afb748639b8b4900f138923ace3e8e\",\"name\":\"Patr\u00edcia Barbosa Maur\u00edcio Vilela\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/07\\\/Patricia.jpg\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/07\\\/Patricia.jpg\",\"contentUrl\":\"https:\\\/\\\/gastropedia.pub\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/07\\\/Patricia.jpg\",\"caption\":\"Patr\u00edcia Barbosa Maur\u00edcio Vilela\"},\"description\":\"-Resid\u00eancia M\u00e9dica em Gastroenterologia e Endoscopia Digestiva pelo HC-FMUSP -Membro titular da FBG -Gastroenterologista e Endoscopista do Hospital Monte Sinai,\u00a0 Juiz de Fora-MG\",\"url\":\"#molongui-disabled-link\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Check-list para iniciar terapia biol\u00f3gica na DII - Gastropedia","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/","og_locale":"pt_BR","og_type":"article","og_title":"Check-list para iniciar terapia biol\u00f3gica na DII","og_description":"Os pacientes com fen\u00f3tipo de DII (Doen\u00e7a Inflamat\u00f3ria Intestinal) moderada a grave e\/ou com fatores de risco para pior progn\u00f3stico, uma vez eleitos para terapia avan\u00e7ada com biol\u00f3gicos, devem passar&hellip;","og_url":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/","og_site_name":"Gastropedia","article_published_time":"2023-08-21T09:27:00+00:00","article_modified_time":"2023-08-22T14:37:36+00:00","og_image":[{"width":563,"height":294,"url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/imag-alex.jpg?v=1668113710","type":"image\/jpeg"}],"author":"Patr\u00edcia Barbosa Maur\u00edcio Vilela","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Patr\u00edcia Barbosa Maur\u00edcio Vilela","Est. tempo de leitura":"5 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#article","isPartOf":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/"},"author":{"name":"Patr\u00edcia Barbosa Maur\u00edcio Vilela","@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/b0afb748639b8b4900f138923ace3e8e"},"headline":"Check-list para iniciar terapia biol\u00f3gica na DII","datePublished":"2023-08-21T09:27:00+00:00","dateModified":"2023-08-22T14:37:36+00:00","mainEntityOfPage":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/"},"wordCount":869,"commentCount":0,"image":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#primaryimage"},"thumbnailUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/imag-alex.jpg?v=1668113710","articleSection":["Gastroenterologia","Intestino"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/","url":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/","name":"Check-list para iniciar terapia biol\u00f3gica na DII - Gastropedia","isPartOf":{"@id":"https:\/\/gastropedia.pub\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#primaryimage"},"image":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#primaryimage"},"thumbnailUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/imag-alex.jpg?v=1668113710","datePublished":"2023-08-21T09:27:00+00:00","dateModified":"2023-08-22T14:37:36+00:00","author":{"@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/b0afb748639b8b4900f138923ace3e8e"},"breadcrumb":{"@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#primaryimage","url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/imag-alex.jpg?v=1668113710","contentUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2022\/11\/imag-alex.jpg?v=1668113710","width":563,"height":294},{"@type":"BreadcrumbList","@id":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/intestino\/check-list-para-iniciar-terapia-biologica-na-dii\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"In\u00edcio","item":"https:\/\/gastropedia.pub\/pt\/"},{"@type":"ListItem","position":2,"name":"Check-list para iniciar terapia biol\u00f3gica na DII"}]},{"@type":"WebSite","@id":"https:\/\/gastropedia.pub\/pt\/#website","url":"https:\/\/gastropedia.pub\/pt\/","name":"Gastropedia","description":"Atualiza\u00e7\u00e3o m\u00e9dica de forma descomplicada para profissionais que trabalham com sa\u00fade do aparelho digestivo.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/gastropedia.pub\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Person","@id":"https:\/\/gastropedia.pub\/pt\/#\/schema\/person\/b0afb748639b8b4900f138923ace3e8e","name":"Patr\u00edcia Barbosa Maur\u00edcio Vilela","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2023\/07\/Patricia.jpg","url":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2023\/07\/Patricia.jpg","contentUrl":"https:\/\/gastropedia.pub\/pt\/wp-content\/uploads\/2023\/07\/Patricia.jpg","caption":"Patr\u00edcia Barbosa Maur\u00edcio Vilela"},"description":"-Resid\u00eancia M\u00e9dica em Gastroenterologia e Endoscopia Digestiva pelo HC-FMUSP -Membro titular da FBG -Gastroenterologista e Endoscopista do Hospital Monte Sinai,\u00a0 Juiz de Fora-MG","url":"#molongui-disabled-link"}]}},"_links":{"self":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/6872","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/users\/5686"}],"replies":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/comments?post=6872"}],"version-history":[{"count":5,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/6872\/revisions"}],"predecessor-version":[{"id":7265,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/posts\/6872\/revisions\/7265"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/media\/3148"}],"wp:attachment":[{"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/media?parent=6872"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/categories?post=6872"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/tags?post=6872"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/ano?post=6872"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/tipo?post=6872"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/gastropedia.pub\/pt\/wp-json\/wp\/v2\/volume?post=6872"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}