Casey Eye Institute.
Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA.
Curr Opin Rheumatol. 2019 Jul;31(4):349-354. doi: 10.1097/BOR.0000000000000619.
The term spondyloarthritis (SpA) encompasses a group of chronic inflammatory disorders of the joints, including ankylosing spondylitis, psoriatic arthritis, reactive arthritis, inflammatory bowel disease, juvenile SpA and undifferentiated SpA. These diseases can also present with uveitis, or intraocular inflammation, which can be controlled with biologics.
Profound success has occurred with the tumor necrosis factor-α inhibitors infliximab and adalimumab, moderate success with certolizumab pegol and golimumab and less encouraging results with etanercept. Promising results have also been demonstrated with interleukin-17 (IL-17) antagonists, such as secukinumab ixekizumab or combined IL-12 and 23 medications, such as ustekinumab.
In cases of uveitis that require long-term control, biologics are an emerging and valuable class of medications for these patients, and may provide avenues to control both their underlying SpA and uveitis manifestations.
脊柱关节炎(SpA)一词涵盖了一组慢性关节炎症性疾病,包括强直性脊柱炎、银屑病关节炎、反应性关节炎、炎症性肠病、青少年 SpA 和未分化 SpA。这些疾病也可能伴有葡萄膜炎,即眼内炎症,可以用生物制剂来控制。
肿瘤坏死因子-α抑制剂英夫利昔单抗和阿达木单抗取得了显著成功,依那西普取得了中等成功,而戈利木单抗的效果则不太理想。白细胞介素-17(IL-17)拮抗剂如司库奇尤单抗、依奇珠单抗也取得了有希望的结果,同时联合使用 IL-12 和 23 药物,如乌司奴单抗也有一定疗效。
对于需要长期控制的葡萄膜炎病例,生物制剂是这些患者新兴的、有价值的一类药物,可能为控制潜在的 SpA 和葡萄膜炎表现提供途径。