Erickson Alan R, Mikuls Ted R
Section of Rheumatology and Immunology, University of Nebraska Medical Center, 988025 Nebraska Medical Center, Omaha, NE 98198-8025, USA.
Curr Rheumatol Rep. 2007 Oct;9(5):416-20. doi: 10.1007/s11926-007-0066-2.
The availability of biologic agents targeting tumor necrosis factor (TNF)-alpha represents a significant advance in the management of rheumatoid arthritis. Anti-TNF-alpha therapy has been associated with dramatic improvements in the clinical signs and symptoms of rheumatoid arthritis and has been shown to greatly retard the destructive process that too often characterizes this condition. Although effective and well-tolerated in a substantial proportion of patients, primary and secondary failures of anti-TNF-alpha strategies have been well described, affecting up to one-third to one-half of subjects treated with these agents. Switching from one anti-TNF-alpha agent to a second (or even third) anti-TNF-alpha therapy has emerged as a means of addressing treatment failures with this drug class. This review examines data addressing the practice of switching anti-TNF-alpha agents in the context of initial treatment failure, with a focus on data from peer-reviewed reports.
靶向肿瘤坏死因子（TNF）-α的生物制剂的出现是类风湿关节炎治疗方面的一项重大进展。抗TNF-α治疗已使类风湿关节炎的临床体征和症状得到显著改善，并已证明能极大地延缓这种疾病常见的破坏进程。尽管在相当一部分患者中有效且耐受性良好，但抗TNF-α治疗策略的原发性和继发性失败情况已有充分描述，接受这些药物治疗的患者中多达三分之一至二分之一受到影响。从一种抗TNF-α药物转换为第二种（甚至第三种）抗TNF-α治疗已成为解决这类药物治疗失败问题的一种方法。本综述研究了在初始治疗失败的情况下转换抗TNF-α药物的相关数据，重点关注同行评审报告中的数据。
