Tocilizumab: a review of its safety and efficacy in rheumatoid arthritis.
Tocilizumab: a review of its safety and efficacy in rheumatoid arthritis.
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DOI：
10.4137/cmamd.s4864
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发表时间：
2010-12-19
期刊：
影响因子：
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通讯作者：
Ding C
中科院分区：
文献类型：
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作者：
Jones G;Ding C
类风湿性关节炎的治疗方法有哪些？托珠单抗（TCZ）是一种单克隆抗体，可抑制白细胞介素-6受体。在日本进行初步研究后，已在五项多中心临床试验中进行了广泛研究。本报告总结了主要临床试验的关键疗效和毒性结果。TCZ在类风湿性关节炎中作为单药治疗或与其他药物联合治疗早期疾病、DMARD应答不足、血清阴性疾病和抗TNF治疗失败后快速有效。毒性特征是可控的，但包括感染（最明显的是皮肤和软组织）、血清胆固醇升高、中性粒细胞计数一过性降低和肝功能检查异常（特别是与甲氨蝶呤联合使用）。总之，有足够的证据表明TCZ是类风湿关节炎的一线生物治疗，特别是对于那些不能服用甲氨蝶呤或抗TNF治疗失败的患者。
Recent years have seen many exciting developments in the treatment of rheumatoid arthritis. Tocilizumab (TCZ) is a monoclonal antibody which inhibits the interleukin-6 receptor. After initial studies in Japan, it has been extensively studied in five multicentre clinical trials. This report summarises the key efficacy and toxicity findings from the major clinical trials. TCZ works quickly and effectively in rheumatoid arthritis either as monotherapy or in combination with other agents in early disease, DMARD inadequate responders, seronegative disease and after anti-TNF failure. The toxicity profile is manageable but includes infections (most notably skin and soft tissue), increases in serum cholesterol, transient decreases in neutrophil count and abnormal liver function tests (especially in combination with methotrexate). In summary, there is sufficient evidence to make TCZ a first line biologic therapy for rheumatoid arthritis especially for those who are unable to take methotrexate or who fail anti-TNF therapy.