类风湿性关节炎的新疗法（A new treatment for rheumatoid arthritis）.doc

类风湿性关节炎的新疗法（A new treatment for rheumatoid arthritis） A new treatment for rheumatoid arthritis After reviewing the literature on rheumatoid arthritis (RA), Dr. 2007-12-08, #e#Abdelaty, noted that over the past several decades, more understanding of the pathogenesis of RA has been contributing to the development of more novel therapies. Improvements in non corticosteroid anti-inflammatory drugs (NSAID) are also beneficial to patients. This article reports on the focus of these new therapies. Anti tumor necrosis factor (TNF) [infliximab (cA2)] therapy: 1. pharmacological action of cA2 is a chimeric anti TNF alpha mAb, which is composed of different parts of mouse anti human TNF alpha monoclonal antibody (mAb) connected to human IgG1 kappa molecule. It has two basic mechanisms: 1 and soluble TNF alpha complex and lose its biological activity and down-regulation of inflammatory events. (II) binding with transmembrane TNF alpha leads to Fc mediated mechanisms that cause TNF alpha cell disruption, thereby reducing inflammatory cell populations. Through this two pathway, both and CSF can be blocked by TNF alpha on other proinflammatory cytokines such as IL 1, IL 6, IL 8 and GM. Another mechanism is to reduce the influx of inflammatory cells into the joint through the reduction of synovial and intracellular adsorptive molecules. 2. clinical efficacy in the United States, cA2 for RA is pending approval. In a placebo-controlled trial of cA2 for the first time in RA, intravenous infusion (IV) with a single cA210mg/kg had a higher efficacy than 1mg/kg (79% versus 44%), and the median duration of maintenance was 8 and 3 weeks, respectively. The placebo group was 12% effective. For relapse, the cA210mg/kg was given up to 4 times, and all cases were effectively controlled, but 50% of patients had a shorter period of validity. This is believed to be due to the formation of human anti chimerism antibodies (HACA). For the first time a placebo-controlled, double-blind, long-term study