Voulgari Paraskevi V, Drosos Alexandros A
University of Ioannina Medical School, Rheumatology Clinic, Department of Internal Medicine, 45110 Ioannina, Greece.
Expert Opin Biol Ther. 2006 Dec;6(12):1349-60. doi: 10.1517/14712598.6.12.1349.
In the last few years significant advances have been made in our understanding of the molecular mechanisms underlying rheumatoid arthritis pathogenesis. Pro-inflammatory cytokines, such as TNF-alpha, play a pivotal role in its pathogenesis. Anti-TNF-alpha biological agents are considered a major advance in the treatment of rheumatoid arthritis. Adalimumab is a fully human monoclonal antibody that binds specifically to TNF-alpha, thereby neutralising its activity. It had significant efficacy in well-designed, placebo-controlled trials in patients suffering from rheumatoid arthritis, both as monotherapy and in combination with various disease-modifying antirheumatic drugs, including methotrexate. Adalimumab was generally well tolerated during both concomitant therapy with methotrexate or standard antirheumatic therapy and monotherapy. In addition, the radiographic progression of structural joint damage was significantly inhibited by adalimumab and improved quality of life. This review summarises the recent available data.
在过去几年中,我们对类风湿性关节炎发病机制背后的分子机制的理解取得了重大进展。促炎细胞因子,如肿瘤坏死因子-α(TNF-α),在其发病机制中起关键作用。抗TNF-α生物制剂被认为是类风湿性关节炎治疗的一项重大进展。阿达木单抗是一种完全人源化单克隆抗体,它特异性结合TNF-α,从而中和其活性。在针对类风湿性关节炎患者进行的精心设计的安慰剂对照试验中,无论是作为单一疗法还是与包括甲氨蝶呤在内的各种改善病情抗风湿药物联合使用,阿达木单抗都具有显著疗效。在与甲氨蝶呤联合治疗或标准抗风湿治疗以及单一治疗期间,阿达木单抗总体耐受性良好。此外,阿达木单抗显著抑制了结构性关节损伤的影像学进展,并改善了生活质量。本综述总结了近期可得的数据。