Aly Aly M, Furst Daniel E
a Alexandria University Faculty of Medicine , Alexandria , Egypt.
b Department of Medicine, Division of Rheumatology , University of California Los Angeles , Los Angeles , CA , USA.
Expert Rev Clin Immunol. 2017 Aug;13(8):741-752. doi: 10.1080/1744666X.2017.1351297.
Sarilumab is a human monoclonal antibody against Interleukin 6 α (IL-6α) receptor. Compared to tocilizumab, another IL-6 α receptor antibody, sarilumab has a different structure and higher affinity. Areas covered: In a systematic literature review, we examined all sarilumab randomized clinical trials (RCTs) in rheumatoid arthritis. The 6 reviewed RCTs included patients who were inadequate MTX, DMARD and/or TNFi responders. Sarilumab 150-200 mg every 2 weeks improved RA signs, symptoms, function and decreased radiological progression up to 52 weeks. The most common adverse events were infections and neutropenia, the latter of which will require careful observation in future trials. Examination of the effect of sero-positivity, disease duration, presence of erosions, use of previous biologic and comparisons to other biologics etc are still needed to complete understanding of this drug's profile. Long term studies, too, will be needed to assess long term tolerability Expert commentary: Results support the use of sarilumab to treat RA patients with inadequate response to MTX, other DMARDs and TNFis, although further studies are needed to fully assess its toxicity and understand the specific place of sarilumab in the RA armamentarium.
萨瑞鲁单抗是一种抗白细胞介素6α（IL-6α）受体的人源单克隆抗体。与另一种IL-6α受体抗体托珠单抗相比，萨瑞鲁单抗具有不同的结构和更高的亲和力。涵盖领域：在一项系统性文献综述中，我们研究了所有类风湿关节炎中萨瑞鲁单抗的随机临床试验（RCT）。所综述的6项RCT纳入了对甲氨蝶呤（MTX）、改善病情抗风湿药（DMARD）和/或肿瘤坏死因子抑制剂（TNFi）反应不足的患者。每2周一次150 - 200毫克的萨瑞鲁单抗改善了类风湿关节炎的体征、症状、功能，并在长达52周的时间里减缓了放射学进展。最常见的不良事件是感染和中性粒细胞减少，后者在未来试验中需要仔细观察。仍需研究血清阳性、疾病持续时间、侵蚀的存在、既往生物制剂的使用以及与其他生物制剂的比较等因素的影响，以全面了解该药物的特性。同样，也需要长期研究来评估长期耐受性。专家评论：结果支持使用萨瑞鲁单抗治疗对MTX、其他DMARD和TNFi反应不足的类风湿关节炎患者，尽管需要进一步研究以充分评估其毒性，并了解萨瑞鲁单抗在类风湿关节炎治疗药物中的具体地位。
