Tocilizumab for treating rheumatoid arthritis: an evaluation of pharmacokinetics/pharmacodynamics and clinical efficacy
Tocilizumab for treating rheumatoid arthritis: an evaluation of pharmacokinetics/pharmacodynamics and clinical efficacy
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DOI：
10.1517/17425255.2015.992779
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发表时间：
2015-01
影响因子：
4.3
通讯作者：
Soken-Nakazawa J. Song;K. Yoshizaki
中科院分区：
文献类型：
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作者：
Soken-Nakazawa J. Song;K. Yoshizaki
前言：IL-6异常过度产生在类风湿关节炎(RA)的发病机制中具有重要作用。托西珠单抗(tocilizumab，TCZ)是唯一被批准用于RA治疗的抑制IL-6途径的生物制剂，也是本综述的重点。内容涉及：本文综述了曲克西平治疗类风湿关节炎患者的药理学特点、临床疗效和安全性。回顾的数据主要基于III期随机临床试验和2014年前关于TCZ治疗RA的文献。专家观点：作为治疗RA的一线生物制剂，TCZ特别适用于对肿瘤坏死因子-α抑制剂反应不足或无法耐受甲氨蝶呤的RA患者。鉴于TCZ在抑制急性时相反应方面的优势，以及作为唯一被批准的IL-6信号转导抑制剂，TCZ可能对由IL-6介导的高全身炎症反应、贫血、AA淀粉样变性等疾病的RA患者特别有效。能够确定TCZ反应的可靠预测因素，并找到更有效的新生物和治疗选择，将减少对TCZ无效的患者数量。
Introduction: Dysregulated overproduction of IL-6 has important roles in the pathogenesis of rheumatoid arthritis (RA). Tocilizumab (TCZ) is the only approved biologic agent inhibiting the IL-6 pathway for RA treatment, and is the focus of this review. Areas covered: This review summarizes the pharmacologic characteristics, clinical efficacy and safety profile of TCZ therapy in RA patients. The data reviewed were based mainly on Phase III randomized clinical trials and the literature until 2014 regarding TCZ in RA treatment. Expert opinion: Being a first-line biologic agent for RA, TCZ is especially suitable for RA patients who have shown an inadequate response to TNF-α inhibitors or who cannot tolerate methotrexate. In view of its advantage in suppressing acute-phase reactions and as the only approved inhibitor of IL-6 signaling, TCZ might be particularly effective for RA patients with a high systemic inflammatory response, anemia, AA amyloidosis and other diseases mediated by IL-6. Being able to identify reliable predictors of response to TCZ, and finding more effective new biologic and treatment options, will reduce the number of patients who fail to respond to TCZ.