{"title":"针对水肿素-4-免疫球蛋白 G 阳性神经脊髓炎视谱系障碍和髓鞘少突胶质细胞糖蛋白抗体相关疾病的单克隆抗体疗法。","authors":"Nanthaya Tisavipat, Hui Y Juan, John J Chen","doi":"10.4103/sjopt.sjopt_102_23","DOIUrl":null,"url":null,"abstract":"<p><p>Monoclonal antibody therapies mark the new era of targeted treatment for relapse prevention in aquaporin-4 (AQP4)-immunoglobulin G (IgG)-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD). For over a decade, rituximab, an anti-CD20 B-cell-depleting agent, had been the most effectiveness treatment for AQP4-IgG+NMOSD. Tocilizumab, an anti-interleukin-6 receptor, was also observed to be effective. In 2019, several randomized, placebo-controlled trials were completed that demonstrated the remarkable efficacy of eculizumab (anti-C5 complement inhibitor), inebilizumab (anti-CD19 B-cell-depleting agent), and satralizumab (anti-interleukin-6 receptor), leading to the Food and Drug Administration (FDA) approval of specific treatments for AQP4-IgG+NMOSD for the first time. Most recently, ravulizumab (anti-C5 complement inhibitor) was also shown to be highly efficacious in an open-label, external-controlled trial. Although only some patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) warrant immunotherapy, there is currently no FDA-approved treatment for relapse prevention in MOGAD. Observational studies showed that tocilizumab was associated with a decrease in relapses, whereas rituximab seemed to have less robust effectiveness in MOGAD compared to AQP4-IgG+NMOSD. Herein, we review the evidence on the efficacy and safety of each monoclonal antibody therapy used in AQP4-IgG+NMOSD and MOGAD, including special considerations in children and women of childbearing potential.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 1","pages":"2-12"},"PeriodicalIF":1.2000,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017007/pdf/","citationCount":"0","resultStr":"{\"title\":\"Monoclonal antibody therapies for aquaporin-4-immunoglobulin G-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.\",\"authors\":\"Nanthaya Tisavipat, Hui Y Juan, John J Chen\",\"doi\":\"10.4103/sjopt.sjopt_102_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Monoclonal antibody therapies mark the new era of targeted treatment for relapse prevention in aquaporin-4 (AQP4)-immunoglobulin G (IgG)-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD). 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Observational studies showed that tocilizumab was associated with a decrease in relapses, whereas rituximab seemed to have less robust effectiveness in MOGAD compared to AQP4-IgG+NMOSD. 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引用次数: 0
摘要
单克隆抗体疗法标志着预防水通道蛋白-4(AQP4)-免疫球蛋白G(IgG)阳性神经脊髓炎视谱系障碍(AQP4-IgG+NMOSD)复发的靶向治疗进入了新时代。十多年来,利妥昔单抗(一种抗 CD20 B 细胞清除剂)一直是治疗 AQP4-IgG+NMOSD 最有效的药物。据观察,抗白细胞介素-6受体的托珠单抗也有一定疗效。2019年,几项随机、安慰剂对照试验相继完成,证明了eculizumab(抗C5补体抑制剂)、inebilizumab(抗CD19 B细胞消耗剂)和satralizumab(抗白细胞介素-6受体)的显著疗效,从而使美国食品和药物管理局(FDA)首次批准了针对AQP4-IgG+NMOSD的特定疗法。最近,在一项开放标签、外部对照试验中,ravulizumab(抗 C5 补体抑制剂)也被证明具有很高的疗效。虽然只有部分髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)患者需要接受免疫疗法,但目前还没有一种经 FDA 批准的用于预防 MOGAD 复发的治疗方法。观察性研究显示,托西珠单抗可减少复发,而利妥昔单抗与AQP4-IgG+NMOSD相比,对MOGAD的疗效似乎不那么明显。在此,我们回顾了用于 AQP4-IgG+NMOSD 和 MOGAD 的每种单克隆抗体疗法的有效性和安全性证据,包括对儿童和育龄妇女的特殊考虑。
Monoclonal antibody therapies for aquaporin-4-immunoglobulin G-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.
Monoclonal antibody therapies mark the new era of targeted treatment for relapse prevention in aquaporin-4 (AQP4)-immunoglobulin G (IgG)-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD). For over a decade, rituximab, an anti-CD20 B-cell-depleting agent, had been the most effectiveness treatment for AQP4-IgG+NMOSD. Tocilizumab, an anti-interleukin-6 receptor, was also observed to be effective. In 2019, several randomized, placebo-controlled trials were completed that demonstrated the remarkable efficacy of eculizumab (anti-C5 complement inhibitor), inebilizumab (anti-CD19 B-cell-depleting agent), and satralizumab (anti-interleukin-6 receptor), leading to the Food and Drug Administration (FDA) approval of specific treatments for AQP4-IgG+NMOSD for the first time. Most recently, ravulizumab (anti-C5 complement inhibitor) was also shown to be highly efficacious in an open-label, external-controlled trial. Although only some patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) warrant immunotherapy, there is currently no FDA-approved treatment for relapse prevention in MOGAD. Observational studies showed that tocilizumab was associated with a decrease in relapses, whereas rituximab seemed to have less robust effectiveness in MOGAD compared to AQP4-IgG+NMOSD. Herein, we review the evidence on the efficacy and safety of each monoclonal antibody therapy used in AQP4-IgG+NMOSD and MOGAD, including special considerations in children and women of childbearing potential.
期刊介绍:
Saudi Journal of Ophthalmology is an English language, peer-reviewed scholarly publication in the area of ophthalmology. Saudi Journal of Ophthalmology publishes original papers, clinical studies, reviews and case reports. Saudi Journal of Ophthalmology is the official publication of the Saudi Ophthalmological Society and is published by King Saud University in collaboration with Elsevier and is edited by an international group of eminent researchers.