Nintedanib for the treatment of systemic sclerosis-associated interstitial lung disease
Nintedanib for the treatment of systemic sclerosis-associated interstitial lung disease
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DOI：
10.1080/1744666x.2020.1777857
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发表时间：
2020-06-18
影响因子：
4.4
通讯作者：
Kuwana, Masataka
中科院分区：
文献类型：
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作者：
Yamasaki, Yoshioki;Kuwana, Masataka
前言间质性肺病(ILD)是系统性硬化症(SSC)患者的主要死亡原因。非特异性免疫抑制剂已成为SSc相关性ILD(SSC-ILD)的一线治疗药物。根据一项安慰剂对照随机对照试验的结果，九替丹尼是一种针对纤维化通路的口服三重酶抑制剂，已被用于治疗特发性肺纤维化，最近在美国和日本获得了上市批准。在这项临床试验中，与安慰剂相比，9tedanib延缓了SSc-ILD的进展。这篇综述涉及的领域包括目前治疗SSc-ILD的药物疗法、9tedanib的药物概况，以及在随机对照试验中观察到的9tedanib对特发性肺纤维化和SSc-ILD患者的疗效和安全性。专家意见目前，我们对SSc-ILD有两种治疗选择，即免疫抑制剂和抗纤维化药物。然而，抗纤维化药物在临床实践中的适当使用仍然具有挑战性，即在哪些情况下使用它们，使用的时机，如何正确使用它们，以及是否与免疫抑制剂联合使用。
Introduction Interstitial lung disease (ILD) is a leading cause of death in patients with systemic sclerosis (SSc). Nonspecific immunosuppressants have been the first-line treatment for SSc-associated ILD (SSc-ILD). Nintedanib, an oral triple kinase inhibitor targeting profibrotic pathways, has been employed for the treatment of idiopathic pulmonary fibrosis and has recently received marketing approval in the United States and Japan, based on the results of a placebo-controlled randomized controlled trial. In this clinical trial, nintedanib delayed the progression of SSc-ILD compared with placebo. Areas covered This review covers current pharmacotherapies for SSc-ILD, drug profiles of nintedanib, and efficacy and safety profiles of nintedanib in patients with idiopathic pulmonary fibrosis and SSc-ILD observed in randomized controlled trails. Expert opinion Currently, we have two treatment options for SSc-ILD, i.e., immunosuppressants and antifibrotic agents. However, appropriate utilization of antifibrotic agents in clinical practice remains challenging, i.e., in which cases they are to be used, timing of use, how to use them properly, and whether in combination with immunosuppressants.