MEDIX, God. 17 Br. 92/93  •  Pregledni članak  •  Reumatologija HR ENG

Biološki lijekovi u spondiloartropatijamaBiologic treatment for spondyloarthropathies

Simeon Grazio, Frane Grubišić

Na temelju suvremenih spoznaja o ulozi čimbenika tumorske nekroze-a (TNF-a) u patogenezi ankilozantnog spondilitisa i psorijatičnog artritisa, razvijena je nova skupina lijekova (nazivaju se i biološkim lijekovima) koji inhibiraju aktivnost TNF-a. To su monoklonska protutijela infliksimab, adalimumab i golimumab, te antagonist receptora, etanercept. U ovom su trenutku u Hrvatskoj odobrena i na listi su HZZO-a sva četiri TNF-a antagonista: infliksimab (kimerično monoklonsko protutijelo), adalimumab i golimumab (humana monoklonska protutijela) i etanercept (solubilni p75 TNF-receptor). Randomizirana, placebom kontrolirana istraživanja pokazala su njihovu učinkovitost i sigurnost primjene, a nedavne metaanalize potvrđuju i njihovu superiornost u usporedbi s tradicionalnim lijekovima koji modificiraju tijek bolesti (engl. disease modifying antirheumatic drugs – DMARD). Antagonisti TNF-a smanjuju simptome bolesti, usporavaju radiološku progresiju bolesti i poboljšavaju funkcionalni status i kakvoću života bolesnika oboljelih od psorijatičnog artritisa i ankilozantnog spondilitisa. 

Ključne riječi:
ankilozantni spondilitis, psorijatični artritis, TNF-a antagonisti

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 17 Br. 92/93

Recent findings on the role of tumour necrosis factor alpha (TNF-alpha) in the pathogenesis of psoriatic arthritis and ankylosing spondylitis have led to the development of a new group of drugs, so-called biologics, which inhibit the activity of TNF alpha. These monoclonal antibodies include infliximab, adalimumab, golimumab and etanercept, a receptor antagonist. Currently, all of these TNF alpha antagonists – infliximab (chimeric monoclonal antibody), adalimumab and golimumab (human monoclonal antibodies) and etanercept (soluble p75 TNF receptor) – have been approved in Croatia and added to the list of expensive drugs reimbursed by the Croatian Institute for Health Insurance. The efficacy and safety profile of these drugs was assessed in randomized placebo-controlled trials, and recent meta-analyses have confirmed their superiority over traditional disease-modifying antirheumatic drugs. TNF alpha antagonists reduce disease symptoms, slow down radiographic progression of disease and improve functional status and quality of life of patients with psoriatic arthritis and ankylosing spondylitis. 

Key words:
antibodies, monoclonal; arthritis, psoriatic; spondylitis, ankylosing; tumor necrosis factor alpha