文献简介

出版社:Elsevier Inc.

作  者:Apostolos Kontzias, and Petros Efthimiou

编  号:10.1016/j.semarthrit.2012.03.004

关键字:adult-onset Still’s disease, anakinra, canakinumab

年  份:2012   点击量:580

文献摘要

Objectives:

目标:

We describe the successful treatment of adult-onset Still’s disease (AOSD) with canakinumab, a novel anti-interleukin (IL)-1β ,long-acting, monoclonal antibody, on patients refractory to anakinra and rilonacept. In many cases the expected positive therapeutic effect of short-acting IL-1 inhibitors is transient or completely absent, leading to our hypothesis that their short half-life may be associated with incomplete IL-1 blockade, given the cyclic nature of the disease.

我们描述了采用康纳单抗,一种新型的抗白细胞介素(IL)-1β ,长效单克隆抗体,成功治疗采用阿那白滞素和利那西普难治的成人斯蒂尔病(AOSD)。在大多情况下,短效的IL- 1抑制剂的预期积极治疗效果是短暂的或完全不存在的,考虑到疾病的循环性质,这导致了我们产生了这一假设,即它们的短半衰期可能与不完整的IL- 1阻断相关联。

Methods:

方法:

We report 2 cases of AOSD resistant to short-acting IL-1 blockade, which were subsequently treated with canakinumab. A retrospective chart review was conducted of patients diagnosed with AOSD in our regional referral center.

我们报道了两例对短效的IL – 1阻断有抵抗作用随后采用康纳单抗治疗的AOSD患者。对在我们地区转诊中心确诊为AOSD的患者进行了一项回顾性的图表总结。

Results:

结果:

Response to treatment was assessed by its effect on the systemic symptoms (resolution of fever and rash), polyarthritis (using the disease activity score 28--C-reactive protein score), and the levels of serum ferritin. Canakinumab demonstrated sustained efficacy in both patients as evidenced by clinical and laboratory parameters with minimal adverse reactions.

通过药物对全身症状(发热和皮疹的消除)、多发性关节炎(使用疾病活动评分28 - C-反应蛋白的分数)和血清铁蛋白水平的作用对治疗效果进行评估。康纳单抗通过伴有最少不良反应的临床和实验室参数证明了其在所有患者中的持久疗效。

Conclusions:

结论:

This is the first documented report of successful use of canakinumab, a novel IL-1β inhibitor, in AOSD patients refractory to traditional disease-modifying antirheumatic drugs and short- to moderate-acting IL-1 blockade. Prospective comparative studies are needed to validate canakinumab’s efficacy and safety.

这是首例记录报告,成功使用康纳单抗,一种新型的IL-1β抑制剂治疗采用传统疾病修饰抗风湿药物和短到中等作用的IL- 1阻断剂难以治愈的AOSD患者。为了验证康纳单抗的疗效及其安全性,还需要进行前瞻性对比研究。