Lutt Joseph R
Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, Oregon, USA.
Open Access Rheumatol. 2009 May 8;1:17-35. doi: 10.2147/oarrr.s4536. eCollection 2009.
The management of rheumatoid arthritis (RA) has undergone an impressive transformation over the past few decades. Further understanding of the pathophysiology of the disease process has resulted in the development of biologic agents that target proinflammatory cytokines and both B and T lymphocytes. By blocking an important costimulatory pathway, abatacept leads to a dramatic reduction in T cell stimulation and proliferation. Multiple clinical trials have revealed consistent benefit with regards to clinical and radiographic efficacy, quality of life, and disability in patients suffering from RA who have had inadequate responses to methotrexate or tumor necrosis factor inhibitors. The possibility of remission when used early in the disease course has also been demonstrated. Importantly, abatacept has been very well tolerated with a low rate of serious infections and no apparent increase in malignancies to date. Continued surveillance of the benefits and risks will help to better define its place amongst the other biologic agents in the treatment of RA.
在过去几十年里，类风湿关节炎（RA）的管理发生了令人瞩目的转变。对疾病进程病理生理学的进一步理解促使了针对促炎细胞因子以及B和T淋巴细胞的生物制剂的研发。通过阻断一条重要的共刺激途径，阿巴西普可显著减少T细胞的刺激和增殖。多项临床试验表明，对于对甲氨蝶呤或肿瘤坏死因子抑制剂反应不佳的RA患者，阿巴西普在临床和影像学疗效、生活质量及残疾状况方面均能持续带来益处。在疾病病程早期使用时实现缓解的可能性也已得到证实。重要的是，阿巴西普耐受性良好，严重感染发生率低，且迄今为止未发现恶性肿瘤有明显增加。对其益处和风险的持续监测将有助于更好地明确它在RA治疗的其他生物制剂中的地位。
