Predicting treatment response to IL6R blockers in rheumatoid arthritis.

Predicting treatment response to IL6R blockers in rheumatoid arthritis.
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DOI:
10.1093/rheumatology/keaa529
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发表时间:
2020-12-01
期刊:
Rheumatology (Oxford, England)
影响因子:
--
通讯作者:
Barton A
Barton A
中科院分区:
其他
文献类型:
--
作者:
Nouri B;Nair N;Barton A

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对常规治疗无反应的重度活动性RA患者可接受生物疾病缓解抗风湿药物(bDMARD)。然而,40%的病例没有达到完全的疾病控制,对患者的生活质量产生了负面影响,并浪费了医疗资源。正在进行的研究旨在建立生物标志物,可用于预测RA生物制剂的治疗反应,以实现更有针对性的治疗方法。然而,大部分工作都集中在一类生物药物上,即TNF抑制剂(TNFi)。在这里,我们将审查目前的研究状况,以确定生物标志物预测的响应类bDMARD靶向IL 6 R。虽然迄今为止成功有限,但血清药物和低ICAM 1水平已显示出希望,独立研究报告了相关性。将讨论研究人员面临的挑战和从TNFi研究中吸取的教训。
Patients with severe, active RA who have not responded to conventional therapy may receive biological disease modifying anti-rheumatic drugs (bDMARDs). However, 40% of cases do not achieve complete disease control, resulting in a negative impact on patient quality of life and representing a waste of healthcare resources. Ongoing research seeks to establish biomarkers, which can be used to predict treatment response to biologics in RA to enable more targeted approaches to treatment. However, much of the work has focused on one class of biologic drug, the TNF inhibitors (TNFi). Here, we will review the current state of research to identify biomarkers predictive of response to the class of bDMARDs targeting the IL6R. While success has been limited thus far, serum drug and low ICAM1 levels have shown promise, with associations reported in independent studies. The challenges faced by researchers and lessons learned from studies of TNFi will be discussed.
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