Brummer Tobias, Ruck Tobias, Meuth Sven G, Zipp Frauke, Bittner Stefan
Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Department of Neurology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Ther Adv Neurol Disord. 2021 Aug 23;14:17562864211035542. doi: 10.1177/17562864211035542. eCollection 2021.
The past decades have yielded major therapeutic advances in many autoimmune conditions - such as multiple sclerosis (MS) - and thus ushered in a new era of more targeted and increasingly potent immunotherapies. Yet this growing arsenal of therapeutic immune interventions has also rendered therapy much more challenging for the attending physician, especially when treating patients with more than one autoimmune condition. Importantly, some therapeutic strategies are either approved for several autoimmune disorders or may be repurposed for other conditions, therefore opening new curative possibilities in related fields. In this article, we especially focus on frequent and therapeutically relevant concomitant autoimmune conditions faced by neurologists when treating patients with MS, namely psoriasis, rheumatoid arthritis and inflammatory bowel diseases. We provide an overview of the available disease-modifying therapies, highlight possible contraindications, show pathophysiological overlaps and finally present which therapeutics can be utilized as a combinatory treatment, in order to 'kill two birds with one stone'.
在过去几十年中,许多自身免疫性疾病(如多发性硬化症)在治疗方面取得了重大进展,从而开启了一个更具针对性、效力日益增强的免疫疗法新时代。然而,这一不断增加的治疗性免疫干预手段也给主治医生的治疗工作带来了更大挑战,尤其是在治疗患有不止一种自身免疫性疾病的患者时。重要的是,一些治疗策略要么已被批准用于多种自身免疫性疾病,要么可能被重新用于其他病症,因此为相关领域开辟了新的治愈可能性。在本文中,我们特别关注神经科医生在治疗多发性硬化症患者时经常遇到且具有治疗相关性的并发自身免疫性疾病,即银屑病、类风湿性关节炎和炎症性肠病。我们概述了现有的疾病修正疗法,强调可能的禁忌症,展示病理生理重叠情况,并最终介绍哪些疗法可作为联合治疗手段,以便“一举两得”。