Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, 120 University Place, G12 8TA Glasgow, UK; Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik, Bad Nauheim, Germany.
Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, 120 University Place, G12 8TA Glasgow, UK.
Best Pract Res Clin Rheumatol. 2014 Aug;28(4):605-24. doi: 10.1016/j.berh.2014.10.017. Epub 2014 Nov 21.
Rheumatoid arthritis (RA) remains a formidable clinical challenge. This is despite remarkable recent advances in our understanding of pathogenesis and the introduction of a variety of novel agents, particularly biologic therapeutics that are potent inhibitors of extracellular immune pathways. Whereas the latter have brought substantial improvements in efficacy and thus outcomes, there remain significant numbers of non- or partial responders to current standard of care. The discovery of key intracellular pathways, particularly kinases that subserve the function of these pivotal cytokine and immune cell receptors implicated in RA pathogenesis, has facilitated the advent of a new phase of RA drug development. Thus, a range of kinase inhibitors has entered clinical trials and one agent has been licenced for use in some regions. Herein we summarise the chequered history of kinase inhibitor development in RA, describing successes and failures alike, and thereafter examine future trends in this exciting field.
类风湿关节炎(RA)仍然是一个严峻的临床挑战。尽管我们对发病机制的理解有了显著的近期进展,并且引入了多种新型药物,特别是能够有效抑制细胞外免疫途径的生物治疗药物,但仍有相当数量的患者对当前的标准治疗没有反应或反应不完全。关键细胞内途径的发现,特别是激酶,它们为 RA 发病机制中涉及的这些关键细胞因子和免疫细胞受体的功能提供服务,促进了 RA 药物开发的新阶段的到来。因此,一系列激酶抑制剂已进入临床试验,一种药物已在某些地区获得许可使用。本文总结了 RA 中激酶抑制剂开发的曲折历史,描述了成功和失败的案例,然后探讨了这一令人兴奋领域的未来趋势。
Best Pract Res Clin Rheumatol. 2014-11-21
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