Institute for Inflammation Research (IIR 7521), Rigshospitalet University Hospital, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark.
Immunotherapy. 2012 Nov;4(11):1167-79. doi: 10.2217/imt.12.114.
This article discusses the rationale behind recommending immunopharmacological guidance of long-term therapies with genetically engineered anti-TNF-α immunoglobulin constructs. Arguments why therapeutic decision-making should not rely on clinical outcome alone are presented. Central to this is that the use of theranostics (i.e., monitoring circulating levels of functional anti-TNF-α drugs and antidrug antibodies) would markedly improve treatment because therapies can be tailored to individual patients and provide more effective and economical long-term therapies with minimal risk of side effects. Large-scale immunopharmacological knowledge of how patients 'handle' TNF-α biopharmaceuticals would also help industry develop more effective and safer TNF-α inhibitors.
本文讨论了对使用基因工程抗TNF-α免疫球蛋白构建体进行长期治疗推荐免疫药理学指导的基本原理。文中提出了为何治疗决策不应仅依赖临床结果的论据。其核心在于，使用治疗诊断学（即监测功能性抗TNF-α药物和抗药物抗体的循环水平）将显著改善治疗效果，因为治疗方案可以根据个体患者量身定制，从而提供更有效且经济的长期治疗，同时副作用风险最小。关于患者如何“处理”TNF-α生物药物的大规模免疫药理学知识，也将有助于制药行业开发更有效、更安全的TNF-α抑制剂。
