摘要
背景:在过去十年中,第一个抗肿瘤坏死因子(TNF)-α药物英夫利昔单抗的引入彻底改变了溃疡性结肠炎(UC)的治疗。然而,这种药物并不是魔术子弹,因为多达50%的UC患者没有反应(主要失败)或失去对英夫利昔单抗(继发性失败)的反应。因此需要新药来填补未满足的医疗需求。 目的:本次审查的目的是讨论可用生物制剂治疗成人中重度UC的随机对照试验(RCTs)的数据,以支持临床决策。 结果和结论:新的生物制剂现在可用于治疗中度UC。阿达木单抗和戈利木单抗是抗TNF-α单克隆抗体,如英夫利昔单抗,而维多珠单抗阻断整联蛋白α4β7/粘膜地址素细胞粘附分子-1(MAd-CAM)。增加治疗性武库提高成功治疗UC的几率,但导致难以选择最合适的生物药物:首先使用哪种生物制剂以及何时以及如何切换。在没有进行头对头试验来回答这些问题的情况下,可用RCT的网络荟萃分析可以提供干预措施之间相对有效性的估计。其他因素,包括患者的便利性和满意度,给药途径,治疗成本以及安全性和有效性等都应该被考虑.
关键词: 抗整联蛋白,抗TNF剂,阿达木单抗,生物疗法,戈利木单抗,英夫利昔单抗,溃疡性结肠炎,维多珠单抗。
图形摘要
Current Drug Targets
Title:Biologic therapies in ulcerative colitis: primi inter pares?
Volume: 19 Issue: 7
关键词: 抗整联蛋白,抗TNF剂,阿达木单抗,生物疗法,戈利木单抗,英夫利昔单抗,溃疡性结肠炎,维多珠单抗。
摘要: Background: In the last decade, the introduction of the first anti-tumor necrosis factor (TNF)-α agent infliximab has revolutionized the treatment of ulcerative colitis (UC). However, this drug is not a magic bullet since up to 50% of UC patients do not respond (primary failure) or lose response to infliximab (secondary failure). Hence the demand for novel drugs to fill the unmet medical need.
Objective: The aim of this review is to discuss the data from randomized controlled trials (RCTs) of available biological agents for the treatment of moderate-to-severe UC in adults, in order to support clinical decision making.
Results and Conclusion: New biological agents are now available for the treatment of moderate-tosevere UC. Adalimumab and golimumab are anti-TNF-α monoclonal antibodies, as is infliximab, whereas vedolizumab blocks the integrin α4β7/mucosal addressin cell adhesion molucule-1 (MAd- CAM). Additions to the therapeutic arsenal boost the chances of successful treatment of UC, but lead to difficulty choosing the most appropriate biological drug: which biologic to use first and when and how to switch. In the absence of head-to-head trials to answer these questions, a network metaanalysis of the available RCTs can provide estimates of relative efficacy between interventions. Other factors, including convenience and satisfaction for the patient, route of administration, the cost of treatment, and the safety and efficacy profile, should all be considered.
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Cite this article as:
Biologic therapies in ulcerative colitis: primi inter pares?, Current Drug Targets 2018; 19 (7) . https://dx.doi.org/10.2174/1389450117666160527142719
DOI https://dx.doi.org/10.2174/1389450117666160527142719 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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