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正确的药物、正确的患者、正确的时间:生物制剂在类风湿关节炎中的应用前景如何?

Right drug, right patient, right time: aspiration or future promise for biologics in rheumatoid arthritis?

机构信息

Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisboa, Portugal.

Department of Rheumatology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Av. Professor Egas Moniz, 1649-035, Lisboa, Portugal.

出版信息

Arthritis Res Ther. 2017 Oct 24;19(1):239. doi: 10.1186/s13075-017-1445-3.

DOI:10.1186/s13075-017-1445-3
PMID:29065909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5655983/
Abstract

Individualising biologic disease-modifying anti-rheumatic drugs (bDMARDs) to maximise outcomes and deliver safe and cost-effective care is a key goal in the management of rheumatoid arthritis (RA). Investigation to identify predictive tools of bDMARD response is a highly active and prolific area of research. In addition to clinical phenotyping, cellular and molecular characterisation of synovial tissue and blood in patients with RA, using different technologies, can facilitate predictive testing. This narrative review will summarise the literature for the available bDMARD classes and focus on where progress has been made. We will also look ahead and consider the increasing use of 'omics' technologies, the potential they hold as well as the challenges, and what is needed in the future to fully realise our ambition of personalised bDMARD treatment.

摘要

个体化生物制剂(bDMARDs)以最大化疗效并提供安全有效的治疗是类风湿关节炎(RA)管理的关键目标。寻找预测 bDMARD 反应的工具是一个非常活跃和多产的研究领域。除了对 RA 患者的临床表型进行评估外,还可以使用不同的技术对滑膜组织和血液进行细胞和分子特征分析,从而促进预测性检测。本文综述了现有的 bDMARD 类药物的相关文献,并重点介绍了取得进展的领域。我们还将展望未来,考虑“组学”技术的广泛应用,以及它们作为潜在工具的优势和挑战,以及未来实现个体化 bDMARD 治疗目标所需的条件。

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A combination of cellular biomarkers predicts failure to respond to rituximab in rheumatoid arthritis: a 24-week observational study.细胞生物标志物组合可预测类风湿关节炎患者对利妥昔单抗治疗无反应:一项为期24周的观察性研究。
Arthritis Res Ther. 2016 Aug 24;18(1):190. doi: 10.1186/s13075-016-1091-1.
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Can baseline serum microRNAs predict response to TNF-alpha inhibitors in rheumatoid arthritis?类风湿关节炎患者的基线血清微小RNA能否预测对肿瘤坏死因子-α抑制剂的反应?
Arthritis Res Ther. 2016 Aug 24;18(1):189. doi: 10.1186/s13075-016-1085-z.
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Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis.众包评估常见遗传因素对预测类风湿关节炎对抗 TNF 治疗反应的作用。
Nat Commun. 2016 Aug 23;7:12460. doi: 10.1038/ncomms12460.
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Factors predicting pain and early discontinuation of tumour necrosis factor-α-inhibitors in people with rheumatoid arthritis: results from the British society for rheumatology biologics register.类风湿关节炎患者中预测肿瘤坏死因子-α抑制剂疼痛及早期停药的因素:来自英国风湿病学会生物制剂登记处的结果
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