生物靶向药物在炎症性肠病中的应用现状

被引:10
作者
李世荣
机构
[1] 北京军区总医院消化内科
关键词
生物靶向药物; 炎症性肠病; 溃疡性结肠炎; 克罗恩病;
D O I
暂无
中图分类号
R574.4 [肠道功能紊乱];
学科分类号
100201 [内科学];
摘要
生物靶向药物如抗肿瘤坏死因子单抗、选择性黏附分子抑制剂等,给难治性炎症性肠病治疗带来了曙光。在诸多生物靶向药物中,英夫利昔单抗(infliximab,IFX,一种人-鼠嵌合体抗肿瘤坏死因子单抗)是近年研究与应用最深入的生物靶向药物。大量循证医学证据提示,IFX和类似的生物靶向药物可显著改进难治性克罗恩病和溃疡性结肠炎的疗效。然而,由于其固有的免疫原性,多次用药后疗效降低和药物输注反应在一定程度上影响了其疗效。提高剂量,缩短用药间隔或换用其他生物制剂可以恢复疗效。合并应用其他免疫抑制剂,或提前输入糖皮质激素可以减少输液反应的发生,但从根本上解决上述问题还需要改变抗体药物本身的免疫原性,如正在研制的纳米抗体便有望解决这些问题。药物诱发的机会感染,特别是结核感染是值得注意的问题。用药前认真进行结核杆菌筛查,如疑有结核病变活动,预先抗结核治疗是非常必要的。
引用
收藏
页码:1750 / 1757
页数:8
相关论文
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溃疡性结肠炎和克罗恩病的英夫利西(类克)治疗效果比较 [J].
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胃肠病学和肝病学杂志, 2010, 19 (07) :644-647
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