Division of Rheumatology, Pusan Paik Hospital, Inje University, Busan, South Korea.
Curr Opin Rheumatol. 2013 Jul;25(4):455-9. doi: 10.1097/BOR.0b013e3283620177.
Inhibitors of tumor necrosis factor (TNF) have demonstrated dramatic clinical efficacy in patients with spondyloarthropathy (SpA). However, not all patients respond, and some patients who initially improve, subsequently lose response. Therefore, there is still an unmet clinical need for additional therapies. Herein we describe the recent data on newer treatments for SpA patients.
Treatments targeting various cytokines, cell surface molecules, and signaling molecules have been assessed. The effects of taregeting B cells with rituximab, T-cell costimulation with abatacept, and interleukin (IL)-6 with tocilizumab have been disappointing in ankylosing spondylitis (AS). Abatacept appears to have a modest effect in patients with psoriatic arthritis (PsA). Targeting IL-17 with secukinumab, IL-12/23 with ustekinumab, and phosphodiesterase 4 (PDE4) with apremilast may prove to be promising treatments for SpA.
There are several newer therapies that may emerge for SpA, particularly those targeting IL-17, IL-23/IL-12, and PDE4.
肿瘤坏死因子（TNF）抑制剂在脊柱关节炎（SpA）患者中表现出显著的临床疗效。然而，并非所有患者均有应答，且一些初始改善的患者随后失去应答。因此，仍存在 SpA 患者对额外治疗的未满足临床需求。本文描述了 SpA 患者新疗法的最新数据。
已评估针对各种细胞因子、细胞表面分子和信号分子的治疗方法。利妥昔单抗靶向 B 细胞、阿巴西普靶向 T 细胞共刺激、托珠单抗靶向白细胞介素（IL）-6 的治疗方法在强直性脊柱炎（AS）中效果令人失望。阿巴西普在银屑病关节炎（PsA）患者中似乎具有一定疗效。司库奇尤单抗靶向 IL-17、乌司奴单抗靶向 IL-12/23、阿普米司特靶向磷酸二酯酶 4（PDE4）可能是 SpA 的有前途的治疗方法。
可能会出现几种治疗 SpA 的新疗法，尤其是针对 IL-17、IL-23/IL-12 和 PDE4 的疗法。
