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[托珠单抗治疗类风湿关节炎]

[Tocilizumab in rheumatoid arthritis].

作者信息

Rueda Gotor Javier, Blanco Alonso Ricardo

机构信息

Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, España.

出版信息

Reumatol Clin. 2011 Mar;6S3:S29-32. doi: 10.1016/j.reuma.2011.01.001. Epub 2011 Mar 23.

Abstract

Tocilizumab (TCZ) is a humanized monoclonal antibody directed against the receptor for IL-6, approved for the treatment of rheumatoid arthritis (RA) in Japan, Europe and the US. Wide clinical development has shown the efficacy of TCZ in most of the possible situations of RA: RA without prior failure to MTX (AMBITION), RA unresponsive to MTX (SATORI, OPTION, LITHE) or any DMARD (TOWARD, ROSE) as well as RA refractory to anti-TNFa agents (RADIATE). In addition to its early onset, efficacy was constant and even increased as time passed (GROWTH95, GROWTH96). TCZ has shown great efficacy in correcting laboratory alterations in RA, both in acute phase reactants as well as anemia of inflammatory disease. Although in RA TCZ us initially indicated in combination with MTX, it has also shown its efficacy as monotherapy (AMBITION). TCZ is equally effective in the prevention of structural damage (SAMURAI, LITHE). In addition, it has shown to be a safe and well-tolerated drug, similar to other biologic therapies. All of these aspects make TCZ an adequate therapeutic alternative to be considered in any RA scenario.

摘要

托珠单抗(TCZ)是一种针对白细胞介素-6受体的人源化单克隆抗体,在日本、欧洲和美国被批准用于治疗类风湿关节炎(RA)。广泛的临床研究表明,TCZ在大多数可能的RA情况下均有效:未先前对甲氨蝶呤(MTX)治疗失败的RA(AMBITION研究)、对MTX无反应的RA(SATORI、OPTION、LITHE研究)或任何传统改善病情抗风湿药(DMARD)(TOWARD、ROSE研究)以及对抗肿瘤坏死因子α(TNFα)药物难治的RA(RADIATE研究)。除起效早外,其疗效持续且随时间推移甚至有所增加(GROWTH95、GROWTH96研究)。TCZ在纠正RA的实验室指标异常方面显示出显著疗效,包括急性期反应物以及炎症性疾病贫血。尽管在RA中TCZ最初被推荐与MTX联合使用,但它作为单药治疗也显示出疗效(AMBITION研究)。TCZ在预防结构损伤方面同样有效(SAMURAI、LITHE研究)。此外,它已被证明是一种安全且耐受性良好的药物,与其他生物疗法相似。所有这些方面使得TCZ成为在任何RA情况下都应考虑的合适治疗选择。

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