http://www.bioon.com 生 物 谷 网 站        欧洲风湿病防治联合会最新数据表明，用rituximab治疗类风湿性关节炎(RA)结果显示其能显著抑制由长期罹患RA疾病引起的关节结构性损伤，以及对一个或更多TNF(肿瘤坏死因子)抑制剂产生不恰当的反应。

        预防风湿性关节炎中关节的结构性损伤是一个关键，许多患者对TNF抑制剂的反应较好，新的治疗方法也可以阻止TNF蛋白引起类风湿性关节炎中的炎症，目前约有30－40％的患者用这种治疗方法。

        研究人员针对rituximab（针对B细胞的新型疗法，B细胞产生的异常抗体会引起风湿性关节炎症状）和甲氨喋呤（一种能抑制DNA、RNA和蛋白质合成的抗代谢药）治疗在1年后对关节结构性损伤产生的效应进行了调查，与单独使用甲氨喋呤相比，风湿性关节炎患者对于一种或更多的TNF抑制剂具有不适反应。

        与对照相比，在这一年的治疗过程中，使用rituximab的患者骨质侵蚀水平降低了一半，并且他们的关节腔狭窄。

        研究结果也显示了使用rituximab和甲氨喋呤治疗联合对于抑制关节结构性损伤具有显著的抑制作用，而且在患者中的一个重要发现是他们目前不会对其它治疗产生不良反应。

        阻止关节损伤则需要打断疾病进程，这也为风湿性关节炎治疗研究指出了一个方向。同时，研究结果也为许多风湿性关节炎患者带来了新的希望。
By European League Against Rheumatism, New data, presented today at the Annual European Congress of Rheumatology show for the first time that a rheumatoid arthritis (RA) treatment, rituximab, is able to significantly inhibit the structural damage to joints caused by RA in patients who have long-standing disease and an inadequate response to one or more TNF (Tumour Necrosis Factor) inhibitors.

Prevention of joint structural damage in rheumatoid arthritis is a critical therapeutic outcome. Many patients respond well to the TNF inhibitors, a relatively new class of therapy which prevents TNF protein causing inflammation in rheumatoid arthritis, however approximately 30% - 40% of patients treated with this therapy experience either an inadequate response or are intolerant to such therapies. As such, the study was designed to investigate the effect at 1 year of rituximab (a new therapy targeting B-cells ?cells which create abnormal antibodies causing rheumatoid arthritis symptoms) plus methotrexate (an antimetabolite drug which inhibits the synthesis of DNA, RNA and protein, previously the gold standard in the treatment of rheumatoid arthritis) on joint structural damage, compared to methotrexate alone in rheumatoid patients with inadequate response to one or more TNF inhibitors.

The results reveal bone erosions in patients in the rituximab group were reduced by over half during the course of a year compared to patients receiving placebo (erosion scores of 0.59 and 1.32 respectively), as were the narrowing of joint spaces (scores of 0.41 and 0.99 respectively). In addition the proportion of patients with no change in erosion score was significantly higher in the rituximab group compared to placebo.

"These findings suggest that treatment with rituximab plus methotrexate is associated with significant inhibition of joint structural damage, an important finding in patients who do not currently respond to other treatments" explained Professor Edward Keystone, Rheumatology Department at the University of Toronto, Canada, one of the studies principle investigators. "Stopping joint damage indicates that the disease pathway has been interrupted, a goal we strive for in the treatment of rheumatoid arthritis. As such, today's results have the potential to offer many patients a new hope".  

- Annual European Congress of Rheumatology in Amsterdam today (Thursday 22 June)

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