Shankar S, Handa R
Department of Medicine, Rheumatology service, All India Institute of Medical Sciences, New Delhi-110029, India.
J Postgrad Med. 2004 Oct-Dec;50(4):293-9.
Rheumatoid arthritis (RA) is the commonest inflammatory joint disease with considerable morbidity and mortality. Conventional disease-modifying antirheumatic drugs like methotrexate form the cornerstone of therapy. However, they have several limitations in terms of slow onset of action, adverse effects and modest remission and retention rates. Several cytokines are involved in the pathogenesis of RA. Biological agents that specifically inhibit the effects of tumour necrosis factor-a (TNF-a) or Interleukin-1 (IL-1) represent a major advancement in the treatment of RA. By targeting molecules that are directly involved in the pathogenesis of RA, these therapies are proving to be efficacious, highly specific and better tolerated than standard therapies. The use of these agents needs to be monitored carefully for possible side-effects, including the development of infections. Additional anti-cytokine agents for the treatment of RA are under further development.
类风湿性关节炎（RA）是最常见的炎性关节疾病，具有相当高的发病率和死亡率。传统的改善病情抗风湿药物如甲氨蝶呤构成了治疗的基石。然而，它们在起效缓慢、副作用以及缓解率和维持率一般等方面存在若干局限性。多种细胞因子参与类风湿性关节炎的发病机制。特异性抑制肿瘤坏死因子-α（TNF-α）或白细胞介素-1（IL-1）作用的生物制剂代表了类风湿性关节炎治疗的一项重大进展。通过靶向直接参与类风湿性关节炎发病机制的分子，这些疗法已被证明是有效的、高度特异性的，并且比标准疗法耐受性更好。使用这些药物时需要仔细监测可能出现的副作用，包括感染的发生。用于治疗类风湿性关节炎的其他抗细胞因子药物正在进一步研发中。
