[炎症性肠病中的新旧生物制剂和小分子药物:抗白细胞介素]

Seung Min Hong, Won Moon
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引用次数: 0

摘要

炎症性肠病(IBD),包括克罗恩病和溃疡性结肠炎,是一种胃肠道慢性炎症性疾病。生物制剂,尤其是抗白细胞介素(IL)制剂的问世,彻底改变了 IBD 的治疗。本综述总结了ILs在IBD病理生理学中的作用,并描述了抗IL疗法的疗效和定位。我们讨论了IBD中关键ILs的功能及其作为治疗靶点的潜力。综述随后讨论了抗IL疗法,主要侧重于乌司替库单抗(抗IL-12/23)、利桑单抗(抗IL-23)和米利库单抗(抗IL-23)。临床试验数据表明,这些药物在诱导和维持克罗恩病和溃疡性结肠炎的缓解方面具有疗效。这些药物的安全性总体良好。然而,新型药物的长期安全性数据仍然有限。本综述还简要讨论了新出现的疗法,如 guselkumab 和 brazikumab。网络荟萃分析表明,与其他生物制剂相比,抗IL疗法表现良好。这些药物可被视为许多患者的一线或二线疗法,尤其是那些有合并症或安全顾虑的患者。抗IL疗法代表了IBD治疗的一大进步,为中重度患者提供了有效且相对安全的选择。
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[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-interleukins].

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a chronic inflammatory disease of the gastrointestinal tract. The introduction of biologics, particularly anti-interleukin (IL) agents, has revolutionized IBD treatment. This review summarizes the role of ILs in IBD pathophysiology and describes the efficacy and positioning of anti-IL therapies. We discuss the functions of key ILs in IBD and their potential as therapeutic targets. The review then discusses anti-IL therapies, focusing primarily on ustekinumab (anti-IL-12/23), risankizumab (anti-IL-23), and mirikizumab (anti-IL-23). Clinical trial data demonstrate their efficacy in inducing and maintaining remission in Crohn's disease and ulcerative colitis. The safety profiles of these agents are generally favorable. However, long-term safety data for newer agents are still limited. The review also briefly discusses emerging therapies such as guselkumab and brazikumab. Network meta-analyses suggest that anti-IL therapies perform well compared to other biological agents. These agents may be considered first- or second-line therapies for many patients, especially those with comorbidities or safety concerns. Anti-IL therapies represent a significant advancement in IBD treatment, offering effective and relatively safe options for patients with moderate to severe disease.

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