Chung Melody P, Paik Julie J
Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Treatm Opt Rheumatol. 2022 Dec;8(4):71-90. doi: 10.1007/s40674-022-00193-6. Epub 2022 Jul 26.
This review highlights current and emerging pharmacologic therapies for the treatment of dermatomyositis (DM). Current clinical evidence, in addition to recently published and ongoing clinical trials for various drugs in development, are summarized in this review.
There has been significant progress in the research and development of potential treatments in DM. The FDA recently approved Octagam 10% Immune Globulin Intravenous (IVIg) for the treatment of DM. Several drug targets are being explored as viable therapeutic options in phase 2 and phase 3 clinical trials; at the forefront of these are JAK inhibitors (tofacitinib and baricitinib) and T-cell co-stimulation blockers (i.e. abatacept). In addition, clinical trials are currently under way for therapeutics targeting novel molecular pathways, including immunoproteasome inhibitors, anti-B cell therapy, anti-interferon drugs, complement inhibitors, and phosphodiesterase-4 inhibitors.
With the large number of clinical trials, multiple novel therapeutics in development, and improved classification and outcome measures, the treatment landscape for DM will continue to rapidly evolve in the coming years as more options become available.
本综述重点介绍目前及新兴的治疗皮肌炎(DM)的药物疗法。除了最近发表的及正在进行的针对各种处于研发阶段药物的临床试验外,本综述还总结了当前的临床证据。
DM潜在治疗方法的研发取得了重大进展。美国食品药品监督管理局(FDA)最近批准了10%静脉注射免疫球蛋白Octagam用于治疗DM。在2期和3期临床试验中,有几个药物靶点正作为可行的治疗选择进行探索;其中最前沿的是JAK抑制剂(托法替布和巴瑞替尼)和T细胞共刺激阻滞剂(即阿巴西普)。此外,目前正在针对靶向新分子途径的疗法进行临床试验,包括免疫蛋白酶体抑制剂、抗B细胞疗法、抗干扰素药物、补体抑制剂和磷酸二酯酶-4抑制剂。
随着大量临床试验、多种处于研发阶段的新型疗法以及分类和结局指标的改善,未来几年,随着更多治疗选择的出现,DM的治疗格局将继续迅速演变。