Choy E
Section of Rheumatology, Department of Medicine, Cardiff University School of Medicine, Cardiff, UK.
J R Coll Physicians Edinb. 2011 Sep;41(3):234-7. doi: 10.4997/JRCPE.2011.312.
Rheumatoid arthritis (RA) is a chronic inflammatory arthritis with many systemic manifestations. Several monoclonal antibodies targeting different components of the immune systems have been licensed for treatment of RA. Inflammatory cytokines such as interleukin-6 (IL-6) are found abundantly in the blood and the joints. The biologic effect of IL-6 on leukocyte, osteoclast, hepatocytes and bone marrow may mediate the articular and systemic inflammation in RA. Recently, an anti-IL-6 receptor monoclonal antibody, tocilizumab, has been licensed for the treatment as monotherapy or in combination with methotrexate of moderate to severe RA, when disease modifying anti-rheumatic drugs or anti-tumour necrosis factors (TNF) have failed. It improves symptoms and signs as well as reducing joint damage. Tocilizumab monotherapy has been shown to be superior to methotrexate. Its side-effects include infections, decrease in neutrophils, and increases in lipid and liver transaminases. Overall, tocilizumab has a well-defined and manageable safety profile that supports a favourable benefit/risk ratio for patients with RA.
类风湿关节炎（RA）是一种具有多种全身表现的慢性炎症性关节炎。几种针对免疫系统不同成分的单克隆抗体已被批准用于治疗RA。诸如白细胞介素-6（IL-6）等炎性细胞因子在血液和关节中大量存在。IL-6对白细胞、破骨细胞、肝细胞和骨髓的生物学效应可能介导了RA中的关节和全身炎症。最近，一种抗IL-6受体单克隆抗体托珠单抗已被批准用于治疗中度至重度RA，可作为单一疗法或与甲氨蝶呤联合使用，适用于病情改善抗风湿药物或抗肿瘤坏死因子（TNF）治疗失败的情况。它可改善症状和体征，并减少关节损伤。托珠单抗单一疗法已被证明优于甲氨蝶呤。其副作用包括感染、中性粒细胞减少以及血脂和肝转氨酶升高。总体而言，托珠单抗具有明确且可控的安全性，对RA患者支持良好的获益/风险比。
