嗜酸性肉芽肿性多血管炎的生物制剂治疗进展

Progress of Biological Agents in Treatment of Eosinophilic Granulomatous with Polyangiitis

嗜酸性肉芽肿性多血管炎(EGPA)发病机制复杂,目前一线治疗方案为糖皮质激素或联合免疫抑制剂,然而对于复发或难治性EGPA治疗效果欠佳。随着对EGPA发病机制的深入研究,临床应用生物制剂治疗EGPA得到重视,生物制剂可减少糖皮质激素的使用剂量,降低疾病复发率,从而改善病情。目前用于EGPA的生物制剂主要包括美泊利单抗、瑞替珠单抗、贝纳珠单抗、利妥昔单抗和奥马珠单抗。但关于生物制剂治疗EGPA的研究多为病例报道,未来应开展多中心、前瞻性、大样本的临床试验来明确生物制剂治疗EGPA的疗效和安全性,同时寻找其他作用靶点的生物制剂类型。

The pathogenesis of eosinophilic granulomatous with polyvasculitis(EGPA)is complex.At present,the first-line treatment is glucocorticoid or combined immunosuppressant,which however is not effective for recurrent or refractory EGPA.With the in-depth study of the pathogenesis of EGPA,more and more attention has been paid to the clinical application of biological agents in the treatment of EGPA.Biological agents can reduce the dose of glucocorticoids,reduce the recurrence rate,and improve the disease condition.At present,the main biological agents used in EGPA are mepolizumab,reslizumab,benralizumab,rituximab and omalizumab.However,at present,most of the studies on biological agents in the treatment of EGPA are case reports.In the future,multicenter,prospective,large sample clinical trials should be carried out to determine the efficacy and safety of biological agents in the treatment of EGPA,while searching biological agent types with other action targets.