Wendling D, Jorgensen C
Service de rhumatologie, centre hospitalier universitaire Jean-Minjoz, 25030 Besançon cedex, France.
Rev Med Interne. 2002 Dec;23(12):1006-11. doi: 10.1016/s0248-8663(02)00736-1.
Interleukin -1 receptor antagonist ( IL-1Ra ) is a new option among biotherapies against rheumatoid arthritis ( RA ).
of this review is to recall the rationale of use of IL-1Ra and to analyse the results available in the current literature.
Pathophysiological data of RA give a specific position for IL-1 as a potential target for immunotherapy in this disease, confirmed in animal models. Phase II and III studies with IL-1Ra (Anakinra) demonstrated clinical efficacy versus placebo (42% responders in ACR 20 in Anakinra + methotrexate, and 23% in the placebo + methotrexate group at 24 weeks) and a structural effect (slowing of radiological progression at six months). Anakinra has obtained an European license and is indicated in RA not controlled by methotrexate, in daily subcutaneous administration (100 mg/day), in combination with methotrexate. Tolerance is fair; the most frequent side effect is represented by injection site reactions.
This ambulatory biotherapy offers new perspectives in combination with other slow acting drugs as well as biologic agents such as anti-TNF, currently under evaluation.
白细胞介素 -1受体拮抗剂（IL-1Ra）是类风湿关节炎（RA）生物治疗中的一种新选择。
是回顾使用IL-1Ra的理论依据，并分析当前文献中的可用结果。
RA的病理生理数据赋予IL-1作为该疾病免疫治疗潜在靶点的特定地位，这在动物模型中得到了证实。使用IL-1Ra（阿那白滞素）的II期和III期研究证明了其相对于安慰剂的临床疗效（在24周时，阿那白滞素 + 甲氨蝶呤组中达到美国风湿病学会20%改善标准的应答者为42%，安慰剂 + 甲氨蝶呤组为23%）以及结构效应（六个月时放射学进展减缓）。阿那白滞素已获得欧洲许可，适用于甲氨蝶呤无法控制的RA，采用每日皮下注射给药（100毫克/天），与甲氨蝶呤联合使用。耐受性尚可；最常见的副作用是注射部位反应。
这种门诊生物治疗与其他慢作用药物以及如抗TNF等生物制剂联合使用时提供了新的前景，目前正在评估中。
