Iannone Florenzo, Scioscia Crescenzio, Falappone Paola C F, Covelli Michele, Lapadula Giovanni
Rheumatology Unit, Department of Internal Medicine and Public Health, University of Bari, Bari, Italy.
J Rheumatol. 2006 Sep;33(9):1802-4.
To evaluate the efficacy of etanercept, a recombinant human soluble fusion protein of tumor necrosis factor-alpha (TNF-alpha) type II receptor and IgG1, in patients with adult dermatomyositis (DM).
Five patients with active DM were studied. All patients reported muscle weakness and had elevated muscle enzymes creatine kinase and lactate dehydrogenase. Because of lack of response to steroid and cytotoxic therapy, etanercept was given at a dose of 25 mg subcutaneously twice a week for at least 3 months.
All patients experienced an exacerbation of disease, with increase of muscle weakness, elevation of muscle enzyme levels, and unchanged rash. Treatment with etanercept was stopped. After receiving a combination of methotrexate (MTX) and azathioprine, disease manifestations improved in all patients.
In our case series, TNF-alpha inhibition by etanercept was not effective, suggesting that a broad immunosuppressive therapy is needed to treat DM.
评估重组人可溶性肿瘤坏死因子-α（TNF-α）Ⅱ型受体与IgG1融合蛋白依那西普对成人皮肌炎（DM）患者的疗效。
对5例活动期DM患者进行研究。所有患者均有肌肉无力症状，且肌酸激酶和乳酸脱氢酶等肌肉酶水平升高。由于对类固醇和细胞毒性疗法无反应，给予依那西普皮下注射，剂量为25毫克，每周两次，至少持续3个月。
所有患者病情均加重，肌肉无力加剧，肌肉酶水平升高，皮疹无变化。依那西普治疗停止。接受甲氨蝶呤（MTX）和硫唑嘌呤联合治疗后，所有患者的疾病表现均有改善。
在我们的病例系列中，依那西普抑制TNF-α无效，提示治疗DM需要广泛的免疫抑制疗法。
