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评估瑞比鲁替尼治疗慢性自发性荨麻疹的效果。

Evaluating remibrutinib in the treatment of chronic spontaneous urticaria.

作者信息

Bożek Agnieszka, Reich Adam

机构信息

Department of Allergology and Cystic Fibrosis, Clinical State Hospital 2 in Rzeszow, Rzeszów, Poland.

Department of Dermatology, Faculty of Medicine, Medical College, University of Rzeszów, Rzeszów, Poland.

出版信息

Immunotherapy. 2025 May;17(7):479-484. doi: 10.1080/1750743X.2025.2510892. Epub 2025 Jun 2.

Abstract

Chronic spontaneous urticaria (CSU) is a complex inflammatory skin condition that significantly impacts patients' quality of life. Conventional treatments, such as antihistamines, often fail to provide adequate symptom control. The next step involves administering omalizumab, a monoclonal antibody targeting IgE, however, a subset of patients may not respond to this treatment underscoring the necessity for alternative treatment options. Remibrutinib, an oral, selective inhibitor of Bruton's tyrosine kinase (BTK), has emerged as a promising therapy in CSU. BTK is vital for the activation of mast cells and basophils. The inhibitory action of remibrutinib on BTK may help alleviate CSU symptoms by addressing mast cell-mediated inflammation. Clinical trials, including Phase II and III studies, have shown promising efficacy and a favorable safety profile for remibrutinib in treating CSU. Patients experienced rapid symptom relief, with notable improvements in the Urticaria Activity Score (UAS7) concerning both itch intensity and the severity of hives. The safety profile was also commendable, with no significant treatment-related adverse events requiring therapy cessation or posing immediate health risks to patients. These results indicate that remibrutinib may become a preferred oral treatment for patients with moderate to severe CSU who do not adequately respond to standard therapies.

摘要

慢性自发性荨麻疹(CSU)是一种复杂的炎症性皮肤病,会严重影响患者的生活质量。传统治疗方法,如使用抗组胺药,往往无法充分控制症状。下一步是使用奥马珠单抗,一种靶向IgE的单克隆抗体,然而,一部分患者可能对这种治疗没有反应,这凸显了替代治疗选择的必要性。瑞帕布替尼是一种口服的布鲁顿酪氨酸激酶(BTK)选择性抑制剂,已成为CSU中有前景的治疗方法。BTK对肥大细胞和嗜碱性粒细胞的激活至关重要。瑞帕布替尼对BTK的抑制作用可能通过解决肥大细胞介导的炎症来帮助缓解CSU症状。包括II期和III期研究在内的临床试验表明,瑞帕布替尼在治疗CSU方面具有有前景的疗效和良好的安全性。患者症状迅速缓解,荨麻疹活动评分(UAS7)在瘙痒强度和荨麻疹严重程度方面都有显著改善。安全性也值得称赞,没有需要停止治疗或给患者带来直接健康风险的重大治疗相关不良事件。这些结果表明,瑞帕布替尼可能成为对标准疗法反应不佳的中度至重度CSU患者的首选口服治疗药物。

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