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首页> 外文期刊>International journal of clinical rheumatology. >Biologic agents in systemic vasculitis
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Biologic agents in systemic vasculitis

机译：系统性血管炎的生物制剂

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The treatment of systemic necrotizing vasculitis has made great strides in both efficacy and outcomes. Standard therapies, however, are associated with numerous side effects, and not all patients will respond to conventional immunosuppression. These realities have prompted the search for safer and more efficacious treatments, most notably among biologic agents. For example, the role of TNF-alpha in the pathophysiology of several vasculitides has led to the investigation of targeted inhibitors of this cytokine, albeit with mixed results. There have been some disappointing results in the area of giant cell arteritis and Wegener's granulomatosis (granulomatosis with polygiitis), but anti-TNF therapy has shown promise in the treatment of Takayasu's arteritis, although additional trials to demonstrate its efficacy are required. Anti-B-cell therapy seems to be the most promising advance in the management of these diseases. Complete and partial responses have been seen in both primary and secondary mixed cryoglobulinemic vasculitis. Recent trials have demonstrated that rituximab is effective for the treatment of Wegener's granulomatosis and microscopic polyangiitis. These trials have, however, raised concerns regarding the long-term safety of these agents. The future holds promise for additional targeted therapies with improved patient response and fewer side effects.
机译：全身性坏死性血管炎的治疗在疗效和预后方面都取得了长足的进步。然而，标准疗法与许多副作用有关，并非所有患者都会对常规免疫抑制产生反应。这些现实促使人们寻求更安全，更有效的治疗方法，尤其是在生物制剂中。例如，TNF-α在几种血管肽的病理生理学中的作用已导致对该细胞因子的靶向抑制剂的研究，尽管结果不一。在巨细胞性动脉炎和韦格纳肉芽肿病（肉芽肿性多发炎）方面取得了令人失望的结果，但是抗TNF疗法在治疗高ak动脉炎方面显示出了希望，尽管还需要其他试验来证明其疗效。抗B细胞疗法似乎是这些疾病管理中最有希望的进步。在原发性和继发性混合性冷珠蛋白性血管炎中均观察到完全和部分反应。最近的试验表明，利妥昔单抗可有效治疗韦格纳肉芽肿和微观多发性血管炎。但是，这些试验引起了人们对这些药物的长期安全性的担忧。未来有望带来更多靶向治疗，改善患者反应，减少副作用。

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