Yukawa Naoichiro, Mimori Tsuneyo
Kyoto University, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine.
Clin Calcium. 2007 Apr;17(4):569-76.
Some patients with rheumatoid arthritis (RA) suffer from disease that is refractory to both conventional therapy and newer biological agents such as tumor necrosis factor (TNF) inhibitors. In recent years, there has been growing interest in, and enhanced understanding of, the contribution of B cells to the immunopathogenesis of RA. Rituximab (RTX), a chimeric monoclonal antibody against CD20 that effectively depletes B cells in peripheral blood, has been licensed for the treatment of malignant lymphoma for almost 10 years. Efficacy of rituximab in RA has already been demonstrated in randomized control trials, and US Food and Drug Administration has approved the combination of RTX with methotrexate for use in patients with RA, who have had an inadequate response to one or more TNF antagonist therapies. The long-term efficacy, especially about joint damage, and long-term safety need to be further investigated.
一些类风湿关节炎（RA）患者的疾病对传统疗法以及肿瘤坏死因子（TNF）抑制剂等新型生物制剂均无效。近年来，人们对B细胞在RA免疫发病机制中的作用越来越感兴趣，并且对此有了更深入的了解。利妥昔单抗（RTX）是一种抗CD20嵌合单克隆抗体，可有效清除外周血中的B细胞，已被批准用于治疗恶性淋巴瘤近10年。利妥昔单抗在RA中的疗效已在随机对照试验中得到证实，美国食品药品监督管理局已批准RTX与甲氨蝶呤联合用于对一种或多种TNF拮抗剂治疗反应不佳的RA患者。其长期疗效，尤其是对关节损伤的疗效，以及长期安全性仍需进一步研究。
