克罗恩病患者最新药物选择研究进展

Advances in drug selection for patients with Crohn’s disease

近年来,抗肿瘤坏死因子(TNF)-α单克隆抗体已成为治疗中重度克罗恩病(CD)的一线用药,但仍有相当比例的患者出现原发性无应答或继发性失应答而致治疗失败,因此急需探究新的疗效与安全性兼顾的药物治疗方案。目前,整合素抑制剂、细胞因子抑制剂等不同机制的生物制剂以及JAK抑制剂、1-磷酸鞘氨醇受体调节剂、反义核酸药物等小分子药物均处于快速研究、发展中,相关临床试验结果提示CD患者可能获益,部分药物已获批上市用于CD的治疗,或将极大改善CD的预后。

Recently, anti-tumor necrosis factor(TNF)–α monoclonal antibodies have become the first-line drugs for the treatment of moderate to severe Crohn’s disease(CD). However, a considerable number of patients still fail the therapy due to primary or secondary loss of response. As a result, other drugs with both efficacy and safety should be considered. Nowadays, biological agents with different mechanisms such as integrin inhibitors and cytokine inhibitors as well as small molecule drugs such as JAK inhibitors, sphingosine-1-phosphate receptor modulators, and antisense nucleic acid drugs are in rapid investigation and development, and the results of relevant clinical trials have suggested possible benefit for CD patients. Among these drugs, some have been marketed for the treatment of CD,and may significantly improve the prognosis of CD.