Eur Heart J:抗白细胞介素1药物用于心包炎治疗

2021-09-18 MedSci原创 MedSci原创

抗IL-1药物似乎是过去5年来复发性心包炎药物治疗中最重要的进展。

抗白细胞介素(IL)-1药物已被开发用于治疗自身炎症和风湿病,其中IL-1产生过多是一个重要的病理生理学过程。IL-1α和IL-1β是IL-1细胞因子家族中研究最多的成员,具有最强的促炎作用。天然存在的拮抗剂(IL-1Ra)可减轻其促炎作用。IL-1α(由炎症/受损的心包细胞释放)和IL-1β(由炎症细胞释放)的过度产生是复发性特发性心包炎患者已知的治疗靶点。

近日,血管领域权威杂志Eur Heart J上发表了一篇研究文章,该研究旨在为临床医生提供关于使用抗IL-1药物治疗心包炎的指导,包括它们的历史背景、它们是如何开发的、它们的作用机制、剂量、副作用和使用技巧。

目前,临床上有三种可用的抗IL-1药物:阿那白滞素(重组人IL-1Ra)、利纳西普(一种可溶性诱饵受体“陷阱”,结合IL-1α和IL-1β)和卡那奴单抗(人单克隆抗IL-1β抗体)。

对于皮质类固醇依赖性和秋水仙碱耐药的复发性心包炎患者,有全身炎症的证据,如C反应蛋白升高,阿那白滞素(2mg/kg/天至100mg/天皮下注射,通常至少6个月,然后逐渐减少)和利洛西普(第一天皮下注射320mg,然后每周皮下注射160mg)的疗效和安全性已在观察性研究和随机对照临床试验中得到了证实。严重的副作用很少见,停药率非常低(<4%)。最常见的副作用是注射部位反应(>50%患者)。

由此可见,抗IL-1药物似乎是过去5年来复发性心包炎药物治疗中最重要的进展。

原始出处:

Massimo Imazio.et al.Anti-interleukin-1 agents for pericarditis: a primer for cardiologists.European Heart Journal.2021.https://doi.org/10.1093/eurheartj/ehab452

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    2021-09-29 13f0c37dm61暂无昵称

    万物相通。

    0

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    2021-09-20 zhaojie88
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    2021-09-20 slcumt
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    2021-09-19 染尘

    厉害

    0

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