Efficacy and safety of the anti-TNF biologic agents
Efficacy and safety of the anti-TNF biologic agents
复制标题
抗TNF生物制剂的功效和安全性
作者：
A. Weaver
在过去的十年中，参与慢性炎症过程的细胞和分子因子的阐明显着增加，有助于类风湿性关节炎（RA）的发病机制。多种证据表明，促炎细胞因子肿瘤坏死因子（TNF）在炎性滑膜炎的持续存在和随后的软骨和骨破坏中起着关键作用，导致在RA中观察到的功能障碍。根据这些发现，已经开发了靶向TNF的新疗法。这些药物治疗RA的一致疗效证实了TNF是该疾病发生的慢性炎症事件和结构损伤的重要介质。其中三种药物（依那西普、英夫利昔单抗和阿达木单抗）在过去5年中已被美国食品药品监督管理局（FDA）批准用于治疗中重度活动性RA。本文将首先解释TNF在炎症和RA中的作用，然后比较和对比各种FDA批准的TNF抑制剂的作用机制，疗效和安全性，并为这些药物之间观察到的临床差异提供可能的解释，特别是在安全性方面。
The last decade has seen a marked increase in the elucidation of cellular and molecular factors involved in chronic inflammatory processes that contribute to the pathogenesis of rheumatoid arthritis (RA). Multiple lines of evidence have demonstrated a critical role for the proinflammatory cytokine tumor necrosis factor (TNF) in the perpetuation of inflammatory synovitis and the subsequent destruction of cartilage and bone that leads to the functional disability observed in RA. In the light of these discoveries, new therapeutics have been developed to target TNF. The consistent efficacy demonstrated by these agents for the treatment of RA has validated TNF as an important mediator of the chronic inflammatory events and structural damage that occur with the disease. Three of these agents (etanercept, infliximab, and adalimumab) have been approved by the United States Food and Drug Administration (FDA) over the last 5 years for treatment of moderately to severely active RA. This article will first explain the role of TNF in inflammation and RA, and then compare and contrast the mechanisms of action, efficacy, and safety profiles of the various FDA-approved TNF inhibitors, as well as offer potential explanations for the clinical differences observed between these agents, especially with regard to safety.
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DOI：
10.1073/pnas.89.16.7375
发表时间：
1992-08-15
影响因子：
11.1
作者：
THORBECKE, GJ;SHAH, R;PALLADINO, MA
通讯作者：
PALLADINO, MA
影响因子：
27.4
作者：
TETTA, C;CAMUSSI, G;BAGLIONI, C
通讯作者：
BAGLIONI, C
类风湿关节炎患者肿瘤坏死因子的滑膜定位。
影响因子：
12.8
作者：
Husby,G;WilliamsJr,RC
通讯作者：
WilliamsJr,RC
影响因子：
--
作者：
Doran, MF;Crowson, CS;Gabriel, SE
通讯作者：
Gabriel, SE