Lorenzo-Vizcaya Ana, Isenberg David A
Department of Internal Medicine, Hospital Universitario De Ourense. Ourense, Spain.
Department of Rheumatology, Division of Medicine, University College London. London, UK.
Expert Opin Biol Ther. 2021 May;21(5):639-647. doi: 10.1080/14712598.2021.1853096. Epub 2021 Jan 6.
Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease characterized by multiple pathologies in which sustained inflammatory activity leads to progressive tissue destruction and organ damage. One of the main proinflammatory cytokines playing a key role in autoimmune diseases such as rheumatoid arthritis (RA) or SLE, is tumor necrosis factor (TNF) alpha.
The introduction of TNF-alpha inhibitors revolutionized the treatment of RA and other conditions including psoriatic arthritis and ankylosing spodylitis. We review here the efficacy and safety of TNF-alpha blockers in SLE focussing on why it has not been more widely used since TNF-alpha was reported to be increased in SLE patients and to correlate with disease activity.
We summarize the reported SLE cases that have received TNF-alpha blockers and the main results to date. We reflect on whether there is a case to reconsider the use of TNF-alpha blockade in SLE.
系统性红斑狼疮（SLE）是一种自身免疫性风湿性疾病，其特征为多种病变，持续的炎症活动会导致进行性组织破坏和器官损伤。在类风湿关节炎（RA）或SLE等自身免疫性疾病中起关键作用的主要促炎细胞因子之一是肿瘤坏死因子（TNF）α。
TNF-α抑制剂的引入彻底改变了RA以及包括银屑病关节炎和强直性脊柱炎在内的其他病症的治疗方法。我们在此回顾TNF-α阻滞剂在SLE中的疗效和安全性，重点关注自报道SLE患者体内TNF-α升高并与疾病活动相关以来，为何它未得到更广泛应用。
我们总结了已接受TNF-α阻滞剂治疗的SLE病例报道及迄今为止的主要结果。我们思考是否有理由重新考虑在SLE中使用TNF-α阻断疗法。
