Pereckova Jana, Martiniakova Silvia, Payer Juraj, Falk Martin, Killinger Zdenko, Perecko Tomas
Center of Experimental Medicine, Slovak Academy of Sciences, Institute of Experimental Pharmacology and Toxicology, Bratislava, Slovak Republic.
Department of Cell Biology and Radiobiology, Institute of Biophysics of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic.
EXCLI J. 2022 Mar 8;21:580-594. doi: 10.17179/excli2022-4702. eCollection 2022.
Administration of biological therapy (BT) in rheumatoid arthritis (RA) patients is often associated with hematological complications, which result in switching among therapies. Thus, there is an instant need for suitable screening parameters that will help to individualize the therapy and minimize the onset of adverse effects. We analyzed the hematological profile of 99 RA patients receiving TNFα (Adalimumab - ADA, Golimumab - GOL, Etanercept - ETA) or IL-6 receptor (Tocilizumab - TCZ) inhibitors in order to find possible indicators to improve personalization of RA therapy. BTs significantly affect the levels of observed hematological parameters. In contrast to TNF-α inhibitors, TCZ normalized almost all monitored hematological parameters to values of healthy donors. Only GOL from the TNF-α inhibitors studied, was able to normalize neutrophil counts, as well as platelet indicators. Importantly, effects on the blood parameters (e.g. lymphocytes or platelet count) differ even within the same therapeutic group (anti-TNFα). Variable effects of individual biological agents in RA treatment point to importance to evaluate the patient's hematological profile to improve the selection of suitable BT. It will help to personalize the administration of BT and prevent unnecessary switching from an effective therapy just because of provocation of avoidable hematological complications.
在类风湿关节炎（RA）患者中使用生物疗法（BT）常常与血液学并发症相关，这会导致治疗方案的切换。因此，迫切需要合适的筛查参数，以帮助实现个体化治疗并将不良反应的发生降至最低。我们分析了99例接受肿瘤坏死因子α（阿达木单抗 - ADA、戈利木单抗 - GOL、依那西普 - ETA）或白细胞介素 - 6受体（托珠单抗 - TCZ）抑制剂治疗的RA患者的血液学特征，以寻找可能改善RA治疗个体化的指标。生物疗法显著影响所观察到的血液学参数水平。与肿瘤坏死因子α抑制剂不同，托珠单抗几乎将所有监测的血液学参数恢复到健康供体的水平。在所研究的肿瘤坏死因子α抑制剂中，只有戈利木单抗能够使中性粒细胞计数以及血小板指标恢复正常。重要的是，即使在同一治疗组（抗肿瘤坏死因子α）内，对血液参数（如淋巴细胞或血小板计数）的影响也存在差异。单个生物制剂在RA治疗中的不同作用表明，评估患者的血液学特征对于改善合适生物疗法的选择至关重要。这将有助于实现生物疗法的个体化给药，并防止仅仅因为引发可避免的血液学并发症而从有效治疗方案中不必要地切换。
