Stokes David G, Kremer Joel M
Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Semin Arthritis Rheum. 2003 Aug;33(1):1-18. doi: 10.1053/sarh.2003.50022.
To consider the potential of tumor necrosis factor (TNF) neutralization in rheumatologic disorders other than rheumatoid arthritis (RA).
Literature on the safety and efficacy of TNF inhibition in the treatment of non-RA arthropathies and systemic inflammatory diseases from American and European medical journals was reviewed.
Clinical trials, open-label studies, and case studies indicate great promise for TNF inhibitors alone or in combination with other protocols in the treatment of non-RA rheumatologic disorders. In randomized, double-blind, placebo-controlled trials of etanercept and open-label studies of infliximab in patients with psoriatic arthritis, these 2 TNF inhibitors resulted in an approximately 80% to 90% response rate. Double-blind, placebo-controlled, randomized trials also indicate an encouraging degree of efficacy in patients with ankylosing spondylitis. Preliminary evidence from open-label trials and case studies suggests that these TNF inhibitors also may be effective in the treatment of Behçet disease, Wegener granulomatosis, and sarcoidosis.
Neutralization of TNF may have an important role in the treatment of rheumatologic disorders other than RA.
探讨肿瘤坏死因子（TNF）中和在类风湿关节炎（RA）以外的风湿性疾病中的潜在作用。
回顾了美国和欧洲医学期刊上关于TNF抑制在治疗非RA关节病和全身性炎症性疾病中的安全性和有效性的文献。
临床试验、开放标签研究和病例研究表明，TNF抑制剂单独使用或与其他方案联合使用在治疗非RA风湿性疾病方面前景广阔。在银屑病关节炎患者中进行的依那西普随机双盲安慰剂对照试验和英夫利昔单抗开放标签研究中，这两种TNF抑制剂的有效率约为80%至90%。双盲安慰剂对照随机试验也表明，强直性脊柱炎患者的疗效令人鼓舞。开放标签试验和病例研究的初步证据表明，这些TNF抑制剂在治疗白塞病、韦格纳肉芽肿和结节病方面也可能有效。
TNF中和在RA以外的风湿性疾病治疗中可能具有重要作用。
