[肿瘤坏死因子α拮抗剂治疗银屑病关节炎]

[Treatment of psoriatic arthritis with TNF alpha-antagonists].

作者信息

Antoni C, Manger B

机构信息

Medizinische Klinik III, Friedrich-Alexander-Universität, Erlangen-Nuremberg, Krankenhausstr. 12, 91054 Erlangen, Germany.

出版信息

Z Rheumatol. 2003 Jun;62(3):235-9. doi: 10.1007/s00393-003-0532-9.

DOI:10.1007/s00393-003-0532-9

PMID:12827399

Abstract

The proinflammatory cytokine TNF alpha is in the pathogenesis of PsA as important as in RA. TNF-alpha is increased in the psoriatic skin lesion and in the synovium of the inflamed joint. The TNF alpha blockage has been tested in double blind trials with etanercept and infliximab. All studies proved a significant and durable response in the reduction of synovitis in a comparable extend in both drugs. Etanercept showed after 12 weeks an ACR20 response in 59% of the patients versus 15% in the placebo arm. Infliximab had after 14 weeks a 69% ACR20 response versus 8% placebo response. The psoriatic skin lesion improved with both drugs. The PASI was reduced by 47% with etanercept and by 81% with infliximab. The safety-profile was similar to the RA-trials. For etanercept the one year data have shown a reduction in x-ray progression. Etanercept has been approved in the USA and in Europe.

摘要

促炎细胞因子肿瘤坏死因子α（TNF-α）在银屑病关节炎（PsA）发病机制中的作用与类风湿关节炎（RA）一样重要。在银屑病皮损及炎症关节的滑膜中，TNF-α水平升高。已使用依那西普和英夫利昔单抗进行双盲试验，以检验TNF-α阻断疗法的效果。所有研究均证明，两种药物在减轻滑膜炎方面均有显著且持久的疗效，且程度相当。12周后，依那西普组59%的患者达到美国风湿病学会20%改善标准（ACR20），而安慰剂组为15%。14周后，英夫利昔单抗组ACR20应答率为69%，安慰剂组为8%。两种药物均能改善银屑病皮损。使用依那西普后，银屑病面积和严重程度指数（PASI）降低了47%，使用英夫利昔单抗后降低了81%。安全性与RA试验相似。依那西普的一年数据显示，X线进展有所减少。依那西普已在美国和欧洲获批。