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首页> 美国卫生研究院文献>Open Access Rheumatology : Research and Reviews >Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders
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Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders

机译：用生物制剂治疗牛皮癣性关节炎的综述：初始治疗的药物选择和无反应者的转换治疗

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Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory disease with a broad clinical spectrum and variable course. It can involve musculoskeletal structures as well as skin, nails, eyes, and gut. The management of PsA has changed tremendously in the last decade, thanks to an earlier diagnosis, an advancement in pharmacological therapies, and a wider application of a multidisciplinary approach. The commercialization of tumor necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab) as well as interleukin (IL)-12/23 (ustekinumab) and IL-17 (secukinumab) inhibitors is representative of a revolution in the treatment of PsA. No evidence-based strategies are currently available for guiding the rheumatologist to prescribe biological drugs. Several international and national recommendation sets are currently available with the aim to help rheumatologists in everyday clinical practice management of PsA patients treated with biological therapy. Since no specific biological agent has been demonstrated to be more effective than others, the drug choice should be made according to the available safety data, the presence of extra-articular manifestations, the patient’s preferences (e.g., administration route), and the drug price. However, future studies directly comparing different biological drugs and assessing the efficacy of treatment strategies specific for PsA are urgently needed.
机译：银屑病关节炎（PsA）是一种异质性慢性炎性疾病，具有广泛的临床范围和可变过程。它可能涉及肌肉骨骼结构以及皮肤，指甲，眼睛和肠道。由于早期诊断，药理学治疗的进步以及多学科方法的广泛应用，PsA的管理在过去十年中发生了巨大变化。肿瘤坏死因子抑制剂（阿达木单抗，塞妥珠单抗，依那西普，戈利木单抗和英夫利昔单抗）以及白介素（IL）-12/23（乌斯替单抗）和IL-17（苏金单抗）的商业化代表了治疗革命PsA。目前尚没有基于证据的策略可指导风湿病医师开具生物药物。当前有几种国际和国家推荐标准集，旨在帮助风湿病学家进行生物疗法治疗的PsA患者的日常临床实践管理。由于没有一种特定的生物制剂被证明比其他药物更有效，因此应根据可获得的安全性数据，关节外表现的存在，患者的喜好（例如给药途径）和药物价格来选择药物。 。然而，迫切需要未来的研究直接比较不同的生物药物并评估针对PsA的治疗策略的有效性。

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