Rheumatoid arthritis: non-tumor necrosis factor targets
Rheumatoid arthritis: non-tumor necrosis factor targets
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类风湿性关节炎：非肿瘤坏死因子靶点
DOI：
10.1097/01.bor.0000159927.19891.eb
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发表时间：
2005
影响因子：
5.1
通讯作者：
E. Choy
中科院分区：
文献类型：
--
作者：
L. Pollard;E. Choy
综述的目的近年来，随着生物治疗的出现，类风湿关节炎的治疗发生了革命性的变化。本文综述了类风湿关节炎中肿瘤坏死因子-α以外的炎症通路的新治疗方法。最新发现随着抗肿瘤坏死因子-α治疗的使用越来越广泛，这种治疗不成功的患者数量也在积累。感染和心力衰竭等禁忌症进一步增加了需要替代治疗的患者数量。对类风湿性关节炎炎症通路的更好理解导致了对其他治疗靶点的兴趣。在过去的一年里，有希望的治疗方法，如白细胞介素-6拮抗剂（MRA），CTLA 4 Ig（阿巴西普）和抗B细胞治疗（利妥昔单抗）已经在随机对照试验中进行了测试。其他细胞因子已被确定，并已被证明是有益的动物模型，包括白细胞介素-15，白细胞介素-17和白细胞介素-18，这些药物的临床试验目前正在进行中。对于抗肿瘤坏死因子-α治疗无效的类风湿性关节炎患者，有希望的替代药物MRA、阿巴西普和利妥昔单抗已经过测试。希望这些代理人不久就能提供。
Purpose of reviewThe treatment of rheumatoid arthritis has been revolutionised in recent years with the advent of biologic treatments. The purpose of this review is to outline new treatments that target the inflammatory pathway in rheumatoid arthritis other than tumor necrosis factor-α. Recent findingsAs the use of anti-tumor necrosis factor-α treatment has become more widespread, the number of patients in whom this treatment is unsuccessful has also accumulated. Contraindications such as infection and cardiac failure further add to the number of patients who need alternative treatment. A better understanding of the inflammatory pathway in rheumatoid arthritis has led to interest in other therapeutic targets. Promising treatments such as interleukin-6 antagonists (MRA), CTLA4Ig (abatacept), and anti-B cell therapy (rituximab) have already been tested in randomized controlled trials over the past year. Other cytokines have been identified and have been shown to be of benefit in animal models, including interleukin-15, interleukin-17, and interleukin-18, and clinical trials of these agents are currently under way. SummaryFor patients with rheumatoid arthritis that does not respond to anti-tumor necrosis factor-α treatment, the promising alternatives MRA, abatacept, and rituximab have been tested. It is hoped that these agents will become available shortly.