抗肿瘤坏死因子-α制剂治疗银屑病关节炎
Anti-TNF-alpha agents in the treatment of psoriatic arthritis.
作者信息
Brandt Jan, Braun Jürgen
机构信息
Rheumazentrum Ruhrgebiet, Landgrafenstr. 15, 44652 Herne, Germany.
出版信息
Expert Opin Biol Ther. 2006 Feb;6(2):99-107. doi: 10.1517/14712598.6.2.99.
Psoriatic arthritis (PsA) is a potentially debilitating disease that may affect small and large peripheral joints, entheses and the axial skeleton. The different clinical manifestations of PsA have been accounted for by various proposals of subdividing the patients into different subgroups. According to the predominant clinical symptoms, most patients can be classified as belonging to the spectrum of spondyloarthritides (SpA) or rheumatoid arthritis (RA). The conventional therapeutic approach comprises non-steroidal anti-inflammatory drugs, systemic and intra-articular corticosteroids, and disease-modifying antirheumatic drugs such as sulfasalazine, methotrexate, ciclosporin and leflunomide. Similar to RA, recent trials in PsA have shown excellent results with the tumour necrosis factor (TNF) blockers etanercept, infliximab and adalimumab, which have positive effects not only on joints, but also on the skin when affected by psoriasis, quality of life, function and slowing of disease progress, as evidenced radiologically. Anti-TNF therapy has been generally safe in clinical trials of PsA. Taken together, there has been definite recent progress in the treatment of PsA, especially for severely affected patients.
银屑病关节炎(PsA)是一种可能导致身体衰弱的疾病,可累及外周小关节和大关节、肌腱附着点及中轴骨骼。针对银屑病关节炎患者的不同临床表现,有多种将患者分为不同亚组的提议。根据主要临床症状,大多数患者可归类为脊柱关节炎(SpA)或类风湿关节炎(RA)谱系。传统治疗方法包括非甾体抗炎药、全身及关节内使用的皮质类固醇,以及改善病情的抗风湿药,如柳氮磺胺吡啶、甲氨蝶呤、环孢素和来氟米特。与类风湿关节炎类似,最近针对银屑病关节炎的试验表明,肿瘤坏死因子(TNF)阻滞剂依那西普、英夫利昔单抗和阿达木单抗疗效显著,这些药物不仅对关节有积极作用,对银屑病累及的皮肤、生活质量、功能以及疾病进展的减缓也有积极作用,影像学检查可证实这一点。在银屑病关节炎的临床试验中,抗TNF治疗总体上是安全的。总体而言,银屑病关节炎的治疗最近取得了明确进展,尤其是对于重症患者。