Roblin Xavier, Rinaudo Melanie, Sparrow Miles Peter, Moreau Amelie, Phelip Jean Marc, Genin Christian, Lamarque Dominique, Paul Stephane
Department of Gastroenterology, CHU de Saint-Etienne, 42023 Saint-Etienne, France.
Curr Drug Targets. 2014;15(11):1049-55. doi: 10.2174/1389450115666140829153509.
This review discusses the rationale behind recommending immunopharmacological guidance of long-term therapies with anti-TNF-α specific biotherapies. "Arguments why therapeutic decision-making should not rely on clinical outcomes 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 clinical benefits while minimising risk of side effects. Large-scale immunopharmacological knowledge of the pharmacokinetics of TNF-α biopharmaceuticals in individual patients would also help industry to develop more effective and safer TNF-α inhibitors" [1].
本综述讨论了推荐使用抗TNF-α特异性生物疗法进行长期治疗的免疫药理学指导背后的基本原理。文中提出了治疗决策为何不应仅依赖临床结果的论据。其中的核心观点是,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,因为可以根据个体患者量身定制治疗方案,在将副作用风险降至最低的同时,提供更有效且经济的长期临床益处。关于TNF-α生物药物在个体患者体内药代动力学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 [1]。