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[类风湿关节炎中的抗CD20疗法]

[Anti-CD20 therapy in rheumatoid arthritis].

作者信息

Roll P, Tony H-P

机构信息

Schwerpunkt Rheumatologie/Klinische Immunologie, Medizinische Klinik und Poliklinik II, Universität Würzburg, Würzburg.

出版信息

Z Rheumatol. 2009 Jul;68(5):370-9. doi: 10.1007/s00393-009-0437-3.

Abstract

The anti-CD20 antibody Rituximab was the first B-cell-specific therapy approved for the treatment of rheumatoid arthritis patients. The basis for its approval in 2006 was the REFLEX study, which examined the administration of 1000 mg Rituximab at 2-week intervals combined with Methotrexat compared with placebo in patients with poor response to TNF-inhibitors in terms of all relevant clinical parameters. Radiological data show that Rituximab is capable of effectively arresting joint destruction. The treatment was well tolerated. The most common side effect, seen in up to 35% of patients, was infusion reactions, particularly during initial Rituximab administration. This could be reduced by approximately 30% with the use of steroid premedication. The serious infection rate in this randomised trial was slightly increased compared with the placebo group, as would also be expected for other biologicals. Data on re-treatment is currently available for up to five treatments and show sustained and/or improved efficacy with continued good tolerance.

摘要

抗CD20抗体利妥昔单抗是首个被批准用于治疗类风湿性关节炎患者的B细胞特异性疗法。2006年其获批的依据是REFLEX研究,该研究在所有相关临床参数方面,对肿瘤坏死因子抑制剂反应不佳的患者中,每隔2周给予1000mg利妥昔单抗联合甲氨蝶呤与安慰剂进行了比较。放射学数据表明,利妥昔单抗能够有效阻止关节破坏。该治疗耐受性良好。高达35%的患者出现的最常见副作用是输液反应,尤其是在初次使用利妥昔单抗期间。使用类固醇预处理可使其降低约30%。与安慰剂组相比,该随机试验中的严重感染率略有增加,其他生物制剂也会出现这种情况。目前已有关于多达五次治疗的再治疗数据,显示疗效持续和/或改善,耐受性持续良好。

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