杨念生. 系统性红斑狼疮药物治疗发展趋势[J]. 协和医学杂志, 2020, 11(3): 247-251. DOI: 10.3969/j.issn.1674-9081.20200061
引用本文: 杨念生. 系统性红斑狼疮药物治疗发展趋势[J]. 协和医学杂志, 2020, 11(3): 247-251. DOI: 10.3969/j.issn.1674-9081.20200061
Nian-sheng YANG. Trends in the Pharmacological Treatment for Systemic Lupus Erythematosus[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 247-251. DOI: 10.3969/j.issn.1674-9081.20200061
Citation: Nian-sheng YANG. Trends in the Pharmacological Treatment for Systemic Lupus Erythematosus[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 247-251. DOI: 10.3969/j.issn.1674-9081.20200061

系统性红斑狼疮药物治疗发展趋势

Trends in the Pharmacological Treatment for Systemic Lupus Erythematosus

  • 摘要: 随着对系统性红斑狼疮(systemic lupus erythematosus, SLE)发病机制研究的深入, SLE治疗进步显著。糖皮质激素等传统药物长期应用可能引起诸多不良反用, 而新药的治疗靶点越来越特异, 同时毒副作应也相应减少。新批准或正在进行临床试验的药物, 如利妥昔单克隆抗体、贝利木单克隆抗体、anifrolumab和巴瑞替尼等, 主要靶点为淋巴细胞、细胞因子及其细胞内信号通路。联合用药可同时阻断多个靶点, 提高疗效。简言之, SLE药物发展是从化学药物到生物制剂再到小分子化学抑制剂的过程, 治疗方式是从非特异性抗炎到特异性免疫抑制以及多靶点治疗的螺旋式上升过程。

     

    Abstract: There have been exciting advances in the treatment for systemic lupus erythematosus(SLE) with a better understanding of the pathogenesis. Since the long term use of traditional medicines such as glucocorticoids may have negative impacts on the outcome, novel treatments have increasingly specific targets that result in fewer adverse side effects. Medicines newly approved or undergoing clinical trials, such as rituximab, belimumab, anifrolumab, and baricitinib, mainly target at lymphocytes, cytokines, or their intracellular signaling pathways. A combinatory treatment that simultaneously blocks multiple targets may bring better efficacy. Development of the pharmacological treatment is a process evolving from chemical agents to biologics and back to small molecule chemical inhibitors. The modality of treatment is involved in a spiral manner from non-specific to specific and then to the combination of multi-target therapy.

     

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