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[类风湿关节炎的新疗法]

[New therapies for rheumatoid arthritis].

作者信息

Salgado Eva, Maneiro José Ramón

机构信息

Servicio de Reumatología, Fundación Ramón Domínguez, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España.

Servicio de Reumatología, Fundación Ramón Domínguez, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España.

出版信息

Med Clin (Barc). 2014 Nov 18;143(10):461-6. doi: 10.1016/j.medcli.2013.11.011. Epub 2014 Jan 22.

Abstract

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by inflammation of the synovial membrane and progressive destruction of the articular cartilage and bone. Advances in the knowledge of disease pathogenesis allowed the identification of novel therapeutic targets such as tumor necrosis factor (TNF), interleukin (IL)-1, IL-6 or the system JAK/STAT phosphorylation. At present there are 5 TNF antagonists approved for RA. Tocilizumab blocks the pathway of IL-6 and is the only biological with proven efficacy in monotherapy. Rituximab modulates B cell response in RA. Abatacept provided new data on T cell involvement in the pathogenesis of RA. Tofacitinib is the first kinase inhibitor approved for this disease. Biologic drugs have proven efficacy, almost always in combination with methotrexate, and even halt radiographic progression. Monitoring infection is the main precaution in handling these patients.

摘要

类风湿关节炎(RA)是一种慢性全身性炎症性疾病,其特征为滑膜炎症以及关节软骨和骨的进行性破坏。疾病发病机制知识的进展使得能够识别新的治疗靶点,如肿瘤坏死因子(TNF)、白细胞介素(IL)-1、IL-6或JAK/STAT磷酸化系统。目前有5种TNF拮抗剂被批准用于治疗RA。托珠单抗阻断IL-6通路,是唯一一种在单药治疗中被证实有效的生物制剂。利妥昔单抗调节RA中的B细胞反应。阿巴西普提供了关于T细胞参与RA发病机制的新数据。托法替布是首个被批准用于该疾病的激酶抑制剂。生物药物已被证实有效,几乎总是与甲氨蝶呤联合使用,甚至能阻止影像学进展。监测感染是治疗这些患者时的主要预防措施。

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