[炎症性肠病中的新老生物制剂和小分子药物:抗肿瘤坏死因子]。

Sang Un Kim, Hyun Seok Lee
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引用次数: 0

摘要

炎症性肠病(IBD)包括溃疡性结肠炎和克罗恩病,是一种以胃肠道炎症复发和缓解为特征的慢性疾病。其发病机制涉及遗传、环境和免疫因素的复杂相互作用。过去几十年来,治疗模式发生了重大变化,生物制剂,尤其是抗肿瘤坏死因子(TNF)制剂的引入标志着重大进步。抗肿瘤坏死因子疗法,包括英夫利昔单抗、阿达木单抗、戈利木单抗和certolizumab pegol,在诱导和维持缓解、促进粘膜愈合和改善中重度IBD患者的生活质量方面具有疗效。早期适当使用这些药物可以缓解疾病进展,减少对皮质类固醇的依赖,从而改善患者的长期预后。然而,这些疗法价格昂贵,且存在潜在的不良反应,包括增加感染和恶性肿瘤的风险。本综述结合当前的韩国治疗指南,讨论了抗肿瘤坏死因子药物在 IBD 治疗中的机制、临床疗效、安全性和治疗定位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-Tumor Necrosis Factors].

Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, is a chronic condition characterized by relapsing and remitting inflammation of the gastrointestinal tract. The pathogenesis involves a complex interplay of genetic, environmental, and immune factors. Treatment paradigms have evolved significantly over the past few decades, with the introduction of biologics, particularly anti-TNF (tumor necrosis factor) agents, marking a significant advancement. Anti-TNF therapies, including infliximab, adalimumab, golimumab, and certolizumab pegol, have efficacy in inducing and maintaining remission, promoting mucosal healing, and improving the quality of life in moderate to severe IBD patients. The early and appropriate use of these agents can mitigate disease progression and reduce the dependency on corticosteroids, enhancing long-term patient outcomes. Nevertheless, these therapies are expensive and are associated with potential adverse effects, including increased risk of infections and malignancies. This review discusses the mechanisms, clinical efficacy, safety profiles, and therapeutic positioning of anti-TNF agents in IBD management, integrating current Korean treatment guidelines.

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