摘要
白塞综合症(BS)是一种累及多系统的血管炎和频繁的皮肤、关节、眼睛和内脏器官受损。从本世纪初,生物药物已越来越多地应用于BS的临床护理,从而在大多数情况下实现快速缓解关键器官受损。尽管目前有类固醇和免疫抑制剂的传统护理经验,生物制剂在治疗耐药病例方面非常有效。在针对BS使用的生物制剂中,TNF-α拮抗剂是最先使用的,其功效已在缓解顽固的眼、胃肠道和神经系统受累血管方面得以证明。这些药物具有显著降低发病率和死亡率,且得到公认的安全性。Tocilizumab、IL-6受体抗体,已被证明对神经系统受累和淀粉样变性的BS患者十分有效;IL1β受体拮抗剂如 anakinra、canakinumab、gevokizumab,能有效缓解眼部受损。IL2受体抗体、secukinumab、IL-17单克隆抗体在BS眼部受损与给药未能表现出明显的临床改善,因而这方面的研究中止。抗血管内皮生长因子拮抗剂、贝伐单抗被证明能有效治疗BS黄斑水肿。其他生物制剂中阿仑单抗和ustekinumab能有效控制疾病症状。在这篇综述中,我们讨论针对不同BS的发病机制,最近开发的各种生物制剂的效用和安全性。
关键词: 阿达木单抗,白塞综合症, 生物制剂,依那西普,抗体,安全性,肿瘤坏死因子,塔西单抗
Current Medicinal Chemistry
Title:Currently Used Biologic Agents in the Management of Behcet’s Syndrome
Volume: 22 Issue: 16
Author(s): Caner Saygin, Didem Uzunaslan and Gulen Hatemi
Affiliation:
关键词: 阿达木单抗,白塞综合症, 生物制剂,依那西普,抗体,安全性,肿瘤坏死因子,塔西单抗
摘要: Behcet’s s yndrome (BS) is a multisystem vasculitis with frequent mucocutaneous, joint, eye and visceral organ involvement. From early 2000s, biologic drugs have been increasingly used in the management of BS, enabling rapid and complete remission in most cases with critical organ involvement. Despite the current experience with steroids and traditional immunosuppressives, biologics are exceptionally promising for treatment of resistant cases. Among the biologics used in BS, TNF-alpha antagonists are the oldest and their efficacy has been proven in recalcitrant ocular, vascular, gastrointestinal and neurologic involvements. These drugs have significantly reduced morbidity and mortality in BS and they have an acceptable safety profile. Tocilizumab, an IL6 receptor antibody, has been shown to be effective in BS patients with neurologic involvement and amyloidosis, and IL1β antagonists such as anakinra, canakinumab, gevokizumab were effective in the management of ocular involvement. Studies investigating the efficacy of daclizumab, IL2 receptor antibody, and secukinumab, IL17 monoclonal antibody, in the management of BS with eye involvement failed to demonstrate significant clinical improvement and both studies were halted. A monoclonal vascular endothelial growth factor antagonist, bevacizumab, was shown to be effective in BS-related macular edema. Alemtuzumab and ustekinumab are among other biologics which were effective in controlling disease symptoms. In this review, we discuss the efficacy and safety of various recently developed biologic agents targeting different pathways involved in the pathogenesis of BS.
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Cite this article as:
Caner Saygin, Didem Uzunaslan and Gulen Hatemi , Currently Used Biologic Agents in the Management of Behcet’s Syndrome, Current Medicinal Chemistry 2015; 22 (16) . https://dx.doi.org/10.2174/0929867322666150209161448
DOI https://dx.doi.org/10.2174/0929867322666150209161448 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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