Mantravadi Santhi, Ogdie Alexis, Kraft Walter K
a Department of Pharmacology and Experimental Therapeutics , Thomas Jefferson University , Philadelphia , PA , USA.
b Department of Medicine, Division of Rheumatology, Perelman School of Medicine , University of Pennsylvania , Philadelphia PA , USA.
Expert Rev Clin Pharmacol. 2017 Aug;10(8):899-910. doi: 10.1080/17512433.2017.1329009. Epub 2017 May 22.
Psoriatic arthritis (PsA) is a chronic inflammatory disease that can result in significant disability. With the emergence of tumor necrosis factor inhibitors (TNFi), therapeutic outcomes in PsA have improved substantially. The clinical efficacy and the inhibition of radiographic progression demonstrated by TNFi have transformed the management of PsA. However, there is still an unmet need for a subset of patients who do not respond adequately to TNFi. Areas covered: This review provides an overview of the pharmacokinetics of TNFi, the efficacy of TNFi in PsA, and the role of immunogenicity of TNFi in the treatment of PsA. In addition, we address the use of TNFi in the setting of other medications utilized in the treatment of PsA and the potential future role of biosimilars. Expert commentary: Monoclonal antibodies exhibit complex and widely variable pharmacokinetics. The study of factors that can affect the pharmacokinetics, such as immunogenicity, is valuable to further define and understand the use of TNFi in PsA, especially in the subset of patients who do not respond adequately to these agents or lose effectiveness over time.
银屑病关节炎（PsA）是一种慢性炎症性疾病，可导致严重残疾。随着肿瘤坏死因子抑制剂（TNFi）的出现，PsA的治疗效果有了显著改善。TNFi所显示的临床疗效和对影像学进展的抑制作用改变了PsA的治疗方式。然而，仍有一部分患者对TNFi反应不佳，存在未满足的需求。涵盖领域：本综述概述了TNFi的药代动力学、TNFi在PsA中的疗效以及TNFi免疫原性在PsA治疗中的作用。此外，我们还讨论了TNFi在PsA治疗中与其他药物联合使用的情况以及生物类似药未来可能发挥的作用。专家评论：单克隆抗体表现出复杂且差异很大的药代动力学。研究影响药代动力学的因素，如免疫原性，对于进一步明确和理解TNFi在PsA中的应用非常有价值，特别是对于那些对这些药物反应不佳或随着时间推移失去疗效的患者亚组。
