Levy Roger A, Guzman Renato, Castañeda-Hernández Gilberto, Martinez-Vazquez Manuel, Damian Guilherme, Cara Carlos
Discipline of Rheumatology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
IDEARG, Saludcoop Clinic, Bogota, Colombia.
Immunotherapy. 2016 Dec;8(12):1427-1436. doi: 10.2217/imt-2016-0067. Epub 2016 Oct 14.
Biologics are increasingly being used to modify the course of immune-mediated inflammatory diseases. Some main agents are monoclonal antibodies and a fusion-protein that target TNF. This group includes adalimumab, infliximab, certolizumab pegol, golimumab and etanercept. Although the efficacy of anti-TNFs is supported by numerous randomized clinical trials, their pharmacokinetics depend on many factors, in particular immunogenicity, which can cause marked and rapid clearance and a consequent decrease in efficacy. Kinetics involve receptors that recognize the Fc fragment of the antibody and are responsible for various processes. Pharmacological advances permit optimizing the pharmacokinetics of anti-TNFs. In this review, we examine the kinetics of anti-TNF biologics, and consequent therapeutic implications, and overview some latest developments in the field. First draftsubmitted: 17 May 2016; Accepted for publication: 15 September2016; Published online: 14 October 2016.
生物制剂越来越多地被用于改变免疫介导的炎症性疾病的病程。一些主要药物是靶向肿瘤坏死因子（TNF）的单克隆抗体和融合蛋白。这一类包括阿达木单抗、英夫利昔单抗、聚乙二醇化赛妥珠单抗、戈利木单抗和依那西普。尽管抗TNF药物的疗效得到了众多随机临床试验的支持，但其药代动力学取决于许多因素，特别是免疫原性，这可能导致药物显著且快速清除，从而使疗效降低。动力学涉及识别抗体Fc片段并负责各种过程的受体。药理学进展使得优化抗TNF药物的药代动力学成为可能。在本综述中，我们研究了抗TNF生物制剂的动力学及其相应的治疗意义，并概述了该领域的一些最新进展。初稿提交日期：2016年5月17日；接受发表日期：2016年9月15日；在线发表日期：2016年10月14日。
