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[类风湿关节炎的药物治疗:生物制剂和新型合成改善病情抗风湿药目前处于什么地位?]

[Drug therapy of rheumatoid arthritis: where do biologics and novel synthetic disease-modifying antirheumatic drugs stand today?].

作者信息

Kaudewitz Dorothee, Lorenz Hanns-Martin

机构信息

Medizinische Klinik V, Klinik für Hämatologie, Onkologie und Rheumatologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.

出版信息

Inn Med (Heidelb). 2023 Oct;64(10):1005-1012. doi: 10.1007/s00108-023-01554-6. Epub 2023 Jul 26.

DOI:10.1007/s00108-023-01554-6
PMID:37493758
Abstract

Biologics and Janus kinase (JAK) inhibitors play an important role in the treatment of rheumatoid arthritis. As new therapeutic developments have emerged in recent decades, the morbidity and mortality of rheumatoid arthritis have been significantly reduced. The characterization of the structure and function of immune cell receptors has led to the development of biologics that specifically inhibit cytokines and immune cell receptors. An important therapeutic addition was the approval of JAK inhibitors, which act directly on intracellular signaling by tyrosine kinases. This article provides an overview of the current therapeutic options for rheumatoid arthritis with a special focus on indication, mechanism of action and the place in the treatment algorithm of biologics and JAK inhibitors.

摘要

生物制剂和 Janus 激酶(JAK)抑制剂在类风湿关节炎的治疗中发挥着重要作用。近几十年来,随着新的治疗方法不断涌现,类风湿关节炎的发病率和死亡率已显著降低。免疫细胞受体结构和功能的特性研究促使了特异性抑制细胞因子和免疫细胞受体的生物制剂的研发。JAK 抑制剂的获批是一项重要的治疗进展,它直接作用于酪氨酸激酶的细胞内信号传导。本文概述了类风湿关节炎目前的治疗选择,特别关注生物制剂和 JAK 抑制剂的适应证、作用机制及其在治疗方案中的地位。

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1
[Drug therapy of rheumatoid arthritis: where do biologics and novel synthetic disease-modifying antirheumatic drugs stand today?].[类风湿关节炎的药物治疗:生物制剂和新型合成改善病情抗风湿药目前处于什么地位?]
Inn Med (Heidelb). 2023 Oct;64(10):1005-1012. doi: 10.1007/s00108-023-01554-6. Epub 2023 Jul 26.
2
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Curr Rheumatol Rep. 2018 May 30;20(7):42. doi: 10.1007/s11926-018-0752-2.

本文引用的文献

1
Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance.托法替尼与肿瘤坏死因子抑制剂治疗伴或不伴动脉粥样硬化性心血管疾病史的类风湿关节炎患者的主要不良心血管事件风险:来自 ORAL Surveillance 的事后分析。
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N Engl J Med. 2022 Jan 27;386(4):316-326. doi: 10.1056/NEJMoa2109927.
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[Treatment of rheumatoid arthritis and spondylarthritis with biologics].[生物制剂治疗类风湿关节炎和脊柱关节炎]
Internist (Berl). 2022 Feb;63(2):135-142. doi: 10.1007/s00108-021-01248-x. Epub 2022 Jan 14.
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[Biologicals and small molecules for rheumatoid arthritis].[用于类风湿性关节炎的生物制剂和小分子药物]
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7
2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus.2019 年欧洲抗风湿病联盟/美国风湿病学会系统性红斑狼疮分类标准。
Ann Rheum Dis. 2019 Sep;78(9):1151-1159. doi: 10.1136/annrheumdis-2018-214819. Epub 2019 Aug 5.
8
Predicting Severe Infection and Effects of Hypogammaglobulinemia During Therapy With Rituximab in Rheumatic and Musculoskeletal Diseases.预测风湿和肌肉骨骼疾病患者在接受利妥昔单抗治疗期间的严重感染和低丙种球蛋白血症的影响。
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[Not Available].[不可用]。
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Apr;62(4):494-515. doi: 10.1007/s00103-019-02905-1.
10
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Rheumatology (Oxford). 2019 Feb 1;58(Suppl 1):i4-i16. doi: 10.1093/rheumatology/key432.