Girard-Guyonvarc'h Charlotte, Iudici Michele
Service de rhumatologie, Département des spécialités de médecine, HUG, Hôpital Beau Séjour, Avenue de Beau-Séjour 26, 1206 Genève.
Rev Med Suisse. 2020 Mar 11;16(685):487-491.
Targeted therapies are nowadays commonly used in connective tissue diseases and vasculitis. Experts recommend the use of belimumab and rituximab in refractory and/or severe cases of lupus. Rituximab can be also considered in difficult to treat cases of Sjögren's disease or myositis. Nintedanib seems a very promising weapon in the management of systemic sclerosis-associated pulmonary fibrosis. Regarding vasculitis, rituximab has become the preferred treatment for granulomatosis with polyangiitis and microscopic polyangiitis. Finally, tocilizumab is recommended as a steroid-sparing agent in giant cell arteritis. Further clinical trials are warranted to study the efficacy of other targeted therapies in connective tissue diseases and vasculitis.
如今，靶向治疗在结缔组织病和血管炎中被广泛应用。专家建议在难治性和/或重症狼疮病例中使用贝利尤单抗和利妥昔单抗。在干燥综合征或肌炎的难治性病例中也可考虑使用利妥昔单抗。尼达尼布似乎是治疗系统性硬化症相关肺纤维化的一种非常有前景的药物。对于血管炎，利妥昔单抗已成为肉芽肿性多血管炎和显微镜下多血管炎的首选治疗药物。最后，托珠单抗被推荐作为巨细胞动脉炎的一种类固醇节约剂。有必要进行进一步的临床试验来研究其他靶向治疗在结缔组织病和血管炎中的疗效。
