Braun Juergen, Landewé Robert Bm
Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands.
Ann Rheum Dis. 2022 Apr;81(4):466-468. doi: 10.1136/annrheumdis-2021-221422. Epub 2021 Oct 16.
The three monoclonal antibodies ustekinumab, guselkumab and risankizumab targeting the p 40 or the 19 subunit of interleukin -23 have now been approved for the indication psoriasis and the former two also for psoriatic arthritis (PsA). Ustekinumab and risankizumab have appeared ineffective in randomised controlled trials with patients with axial spondyloarthritis (axSpA), but post-hoc analyses of PsA trials have now suggested that they may improve back pain symptoms potentially induced by axial inflammation based on PsA. Here we argue that, based on the absence of efficacy in axSpA, this is unlikely and more probably due to generic, non-specific effects, which are not adequately covered by the tools developed for the assessment of inflammation in axSpA.
三种靶向白细胞介素-23的p40或19亚基的单克隆抗体——优特克单抗、古塞库单抗和瑞莎珠单抗，现已获批用于银屑病适应症，前两种还获批用于银屑病关节炎（PsA）。在针对轴性脊柱关节炎（axSpA）患者的随机对照试验中，优特克单抗和瑞莎珠单抗似乎无效，但PsA试验的事后分析现已表明，基于PsA，它们可能改善由轴向炎症潜在引发的背痛症状。在此我们认为，基于在axSpA中缺乏疗效这一情况，这不太可能，更可能是由于一般的非特异性效应，而用于评估axSpA炎症的现有工具并未充分涵盖这些效应。
