abatacept在类风湿性关节炎的管理。

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Nogid,范教授DQ

abatacept在类风湿性关节炎的管理。

其他。2006年11月,28 (11):1764 - 78。

PubMed ID
17212998 (在PubMed
]
文摘

背景:类风湿性关节炎(RA)已经与重大的发病率和经济负担。传统药物治疗(如非甾体抗炎药、糖皮质激素、疾病修饰治疗风湿病的药物(DMARDs))可以控制症状和疾病进展不足。Abatacept选择性co-stimulation调制器是第一个由美国食品和药物管理局批准为RA的管理。这是一个融合蛋白调节t细胞co-stimulatory开发通过CD28-CD80/86通路介导的信号。目的:本手稿的目的是审查临床药理学、药代动力学和药效学特性,耐受性,abatacept的临床疗效。方法:MEDLINE和国际制药抽象是在6月和5月,2006年分别使用术语abatacept或CTLA4-Ig。所有前瞻性,随机,第二和第三阶段试验,和他们的扩展阶段,都包括在内。结果:II和III期临床试验发现,abatacept 10毫克/公斤的剂量服用短静脉输液灌注结合DMARDs,与活跃的RA患者的重要临床益处。6个月的治疗后,美国风湿病学院(ACR)标准20%的临床改善(ACR20响应)获得41.9%到67.9%的病人abatacept相比,19.5%到39.7%的病人安慰剂(P < 0.001)。病人的比例达到ACR 50%和70%的标准临床改善(ACR50和ACR70) 20.3%到39.9%和10.2%到19.8%,分别在组织接受abatacept比例为3.8%到16.8%和1.5%到6.5%,分别在病人安慰剂(P = 0.03, P < 0.001)。 Additionally, abatacept was found to improve disease activity, physical function, pain, and health-related quality of life (HRQOL). The most commonly reported adverse effects associated with abatacept treatment were headache (18.2%), upper respiratory tract infection (12.7%), nasopharyngitis (11.5%), and nausea (11.5%). The incidences of infections and serious infections were higher in the group that received abatacept compared with patients who received placebo (53.8% vs 48.3% and 3.0% vs 1.9%, respectively; P not reported). No significant between-group differences in mortality were found. CONCLUSIONS: Available evidence suggests that abatacept was effective in controlling symptoms and improving HRQOL in patients with active RA and an inadequate response to DMARD therapy. The most commonly reported adverse effects associated with abatacept treatment were headache, upper respiratory infection, nausea, and nasopharyngitis. Additional trials are needed to determine the long-term safety profile of this agent and whether the clinical benefits of abatacept found in the current clinical trials will be sustained over time.

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