治疗类风湿关节炎的新型生物制剂阿贝西普

(510120)1[]T21,,1(rheumatoidarthritis,RA),RA,(diseasemodifyingantirheumaticdrug,DMARD)RA20,2(tumornecrosisfactor2,TNF2),TNF2,,T4(cytotoxicTlymphocyteassociatedantigen4,CTLA4),TCT2LA42IgCTLA4IgG1Fc,(abatacept)1CTLA42Ig,2005-09-06RA2T2:1,T(antigenpresentingcell,APC)(majorhistocompatibilitycomplex,MHC);2TAPC2,TG0G1,,22,T,,T,TTADA(1999),CD28,,CD28,RAT,T,CD282CD80/CD86,22(bcl2xl)[1]CD80(B721)CD86(B722),,BAPCTCD28CTLA4,CD28T,CTLA4T,T,CTLA4,TCD28CTLA42,T,TCTLA4CD80/CD86CD28CD80/CD8620,CT2LA4T,CTLA4IgG1Fc,1CTLA42Ig,CD28B72T,T,T,RAT,RA3311,1,1,10,,RA[2]312,1,RA[3,4]339RA10mg/kg2mg/kg,11530,1,,(1030mg)6,360%42%35%(AmericanCol2legeofRheumatology,ACR)RA20%,ACR20,10mg/kgACR20(P0101)10mg/kg2mg/kgACR50(ACRRA50%)ACR70(ACRRA70%),11862007103810©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(16%),10mg/kg1,90RA015mg/kg2mg/kg10mg/kg,1152957[5]2mg/kg44%12ACR20,10mg/kg53%,015mg/kg31%23%,015mg/kg12,015mg/kg,10mg/kg2mg/kg,,WEINBLATT(2002)1,121RA[2mg/kg1(TNF2)25mg21](,)48%ACR20,28%(P0105)2,RA,,652(10mg/kg11529,281,15mg)()[6]6,268%40%ACR20,12,273%40%ACR20,(016311140158111811212132,P0105P0101),,TNF2RA6ACR2050%20%(P0101),TNF2RA[7]4DMARD:DMARD(95%),()7%4%,;,DMARD(30%)2005,COMBEDMARD,,,TNF2,MORELAND(2005)5(85),,,,,(TNF2),,,:,;;3;COPDRA,COPDRA;5,RA,,,TNF2RA,DMARD,,[][1]SALOMONB,BLUESTONEJA1ComplexitiesofCD28/B7:CTLA24cos2timulatorypathwaysinautoimmunityandtransplantation[J]1AnnuRevIm2munol,2001,19(1):22522521[2]DAIKHDI,WOFSYD1Cuttingedge:reversalofmurinelupusnephritiswithCTLA4Igandcyclophosphamide[J]1JImmunol,2001,166(5):2913229161[3]KREMERJM,WESTHOVENSR,LEONM,etal1Treatmentofrheuma2toidarthritisbyselectiveinhibitionofT2cellactivationwithfusionproteinCTLA4Ig[J]1NEnglJMed,2003,349(20):1907219151[4]KREMERJM,DOUGADOSM,EMERYP,etal1Treatmentofrheuma2toidarthritiswiththeselectivecostimulationmodulatorabatacept:twelve2monthresultsofaphaseiib,double2blind,randomized,placebo2controlledtrial[J]1ArthritisRheum,2005,52(8):2263222711[5]MORELANDLW,ALTENR,VANDENBOSCHF,etal1Costimulatoryblockadeinpatientswithrheumatoidarthritis:apilot,dose2finding,double2blind,placebo2controlledclinicaltrialevaluatingCTLA24IgandLEA29Yeighty2fivedaysafterthefirstinfusion[J]1ArthritisRheum,2002,46(6):1470214791[6]KREMERJM,GENANTHK,MORELANDLW,etal1Effectsofabata2ceptinpatientswithmethotrexate2resistantactiverheumatoidarthritis:aran2domizedtrial[J]1AnnInternMed,2006,144(12):86528761[7]GENOVESEMC,BECKERJC,SCHIFFM,etal1Abataceptforrheu2matoidarthritisrefractorytotumornecrosisfactorinhibition[J]1NEnglJMed,2005,353(11):1114211231(:2007-07-05)(:)2862007103810©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.