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司库奇尤单抗:一种用于治疗银屑病关节炎的抗白细胞介素-17A单克隆抗体。

Ixekizumab: an anti- IL-17A monoclonal antibody for the treatment of psoriatic arthritis.

作者信息

Toussirot Eric

机构信息

a INSERM CIC-1431 , University Hospital of Besançon, Clinical Investigation Center in Biotherapy , Besançon , France.

b Fédération Hospital-Universitaire INCREASE , University Hospital of Besançon , Besançon , France.

出版信息

Expert Opin Biol Ther. 2018 Jan;18(1):101-107. doi: 10.1080/14712598.2018.1410133. Epub 2017 Nov 29.

Abstract

Psoriatic arthritis (PsA) is an inflammatory rheumatic disease that manifests itself with synovitis, dactylitis, enthesitis and also axial involvement. Interleukin-17A has been identified as a master cytokine in the inflammatory response and pathogenesis of PsA and spondyloarthritis in general. Ixekizumab is a new humanized monoclonal antibody that blocks the biological activity of IL-17A. This biological agent has previously demonstrated a high level of efficacy in psoriasis. Areas covered: This review discusses the basic immunology of the IL-17 cytokine family, the contribution of IL-17A to the immunopathogenesis of PsA, the clinical trials that evaluated ixekizumab in patients with PsA (SPIRIT program) and the safety of this agent. Expert opinion: Ixekizumab demonstrated its efficacy in different aspects of PsA including peripheral joint involvement, dactylitis, skin symptoms and patient reported outcomes in the 2 phase III trials from the SPIRIT program. Its safety profile was consistent with previous observations in patients with psoriasis. The role of IL-17A in the management of patients with PsA needs further clarification. According to EULAR recommendations for the management of PsA, IL-17A inhibitors may be used as second line biological DMARDs after TNF inhibitors.

摘要

银屑病关节炎(PsA)是一种炎症性风湿性疾病,表现为滑膜炎、指(趾)炎、附着点炎以及脊柱受累。白细胞介素-17A已被确定为PsA以及一般脊柱关节炎炎症反应和发病机制中的主要细胞因子。司库奇尤单抗是一种新型人源化单克隆抗体,可阻断IL-17A的生物活性。这种生物制剂此前已在银屑病中显示出高度疗效。涵盖领域:本综述讨论了IL-17细胞因子家族的基础免疫学、IL-17A对PsA免疫发病机制的作用、评估司库奇尤单抗治疗PsA患者的临床试验(SPIRIT项目)以及该药物的安全性。专家观点:司库奇尤单抗在SPIRIT项目的两项III期试验中,在PsA的不同方面均显示出疗效,包括外周关节受累、指(趾)炎、皮肤症状以及患者报告的结局。其安全性与先前在银屑病患者中的观察结果一致。IL-17A在PsA患者管理中的作用需要进一步阐明。根据欧洲抗风湿病联盟(EULAR)关于PsA管理的建议,IL-17A抑制剂可在肿瘤坏死因子(TNF)抑制剂之后用作二线生物改善病情抗风湿药(bDMARDs)。

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