Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China.
Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
J Gastroenterol. 2018 Sep;53(9):989-998. doi: 10.1007/s00535-018-1479-6. Epub 2018 Jul 6.
Crohn's disease (CD) is a chronic, progressive, and destructive disease of the gastrointestinal tract. Although its incidence appears to be stable or decreasing in most countries in the North America and Europe, the incidence is rising rapidly in Asian countries. Immunomodulators and biologics are increasingly used to avoid long-term bowel damage and subsequent disability. Therapeutic drug monitoring facilitates optimizing thiopurines and anti-TNFs use. New biologic agents targeting various pathological pathways of CD are blooming in recent years, and the high cost of biologics and expiration of patents for several biologic agents have driven the utility of biosimilars for CD treatment. Here, the literature regarding the efficacy, safety, and withdrawal of the drugs, as well as the evolution of therapeutic targets will be reviewed.
克罗恩病(CD)是一种慢性、进行性、破坏胃肠道的疾病。尽管在北美和欧洲的大多数国家,其发病率似乎稳定或下降,但在亚洲国家,发病率正在迅速上升。免疫调节剂和生物制剂越来越多地被用于避免长期肠道损伤和随后的残疾。治疗药物监测有助于优化硫嘌呤和抗 TNFs 的使用。近年来,针对 CD 各种病理途径的新型生物制剂如雨后春笋般涌现,生物制剂的高成本和几种生物制剂专利的到期,推动了生物类似药在 CD 治疗中的应用。在这里,将回顾这些药物的疗效、安全性和停药情况,以及治疗靶点的演变。