Wollenhaupt J, Krüger K
Abteilung Rheumatologie und klinische Immunologie, Schön-Klinik Hamburg-Eilbek, 22081 Hamburg, Deutschland.
Z Rheumatol. 2010 Sep;69(7):618-25. doi: 10.1007/s00393-009-0532-5.
The spectrum of agents available for the treatment of rheumatoid arthritis (RA) has become more diversified: In addition to TNF-blocking agents, Abatacept, Rituximab and Tocilizumab have now become available for the treatment of RA. All three agents were approved for patients with insufficient response/intolerability to TNF-blockers; Tozilizumab and Abatacept have also been approved for TNF-naive patients with insufficient response to Methorexate.The present article clarifies the efficacy of these three substances in the treatment algorithm of RA. Current data do not suggest differences in general; therefore, individual considerations may result in patient-specific decisions as to which drug should be used after insufficient response to a TNF-blocking agent or Methotrexate. Possible arguments are discussed.
可用于治疗类风湿性关节炎(RA)的药物种类已变得更加多样化:除了肿瘤坏死因子(TNF)阻断剂外,阿巴西普、利妥昔单抗和托珠单抗现在也可用于治疗RA。这三种药物均已获批用于对TNF阻断剂反应不足/不耐受的患者;托珠单抗和阿巴西普也已获批用于对甲氨蝶呤反应不足的初治TNF患者。本文阐明了这三种药物在RA治疗方案中的疗效。目前的数据总体上未显示出差异;因此,在对TNF阻断剂或甲氨蝶呤反应不足后,个体因素可能会导致针对特定患者决定使用哪种药物。文中讨论了可能的依据。