Ha Christina, Mathur Jagrati, Kornbluth Asher
Division of Digestive Diseases, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.
Expert Rev Gastroenterol Hepatol. 2015 Apr;9(4):497-505. doi: 10.1586/17474124.2015.983079. Epub 2015 Jan 20.
The anti-tumor necrosis factor-α (TNF) antibodies have revolutionized the management of ulcerative colitis and Crohn's disease. The development of assays to allow for the measurements of serum drug levels and anti-drug antibodies have provided a more objective means of therapeutic decision making, particularly among patients losing response to treatment. Additionally, more evidence is emerging that indicates the relationship between drug levels and response to therapy including clinical response, mucosal healing and sustained remission. The use of combination therapies of the anti-TNF agents and the thiopurine immunosuppressants may also decrease immunogenicity to the anti-TNF agents and potentiate response to therapy. With more evidence emerging evidence of the importance of therapeutic drug levels and anti-drug antibodies, clinicians may be able to better optimize the current arsenal of inflammatory bowel disease therapeutics to achieve greater rates of durable remission and improved quality of life.
抗肿瘤坏死因子-α（TNF）抗体彻底改变了溃疡性结肠炎和克罗恩病的治疗方式。能够测量血清药物水平和抗药物抗体的检测方法的发展，为治疗决策提供了更客观的手段，尤其是在对治疗失去反应的患者中。此外，越来越多的证据表明药物水平与治疗反应之间的关系，包括临床反应、黏膜愈合和持续缓解。抗TNF药物与硫嘌呤免疫抑制剂联合使用，也可能降低对抗TNF药物的免疫原性，并增强治疗反应。随着越来越多的证据表明治疗药物水平和抗药物抗体的重要性，临床医生或许能够更好地优化目前的炎症性肠病治疗手段，以实现更高的持久缓解率并改善生活质量。
