Neue Entwicklungen in der Biologikatherapie

M. Geyer; W. Hermann; U. Müller-Ladner

doi:10.1055/s-0037-1620171

Arthritis und Rheuma, Table of Contents

Arthritis und Rheuma 2009; 29(04): 244-249
DOI: 10.1055/s-0037-1620171

Biologika in der Rheumatologie – zehn Jahre Anti-TNF-Therapie

Schattauer GmbH

Neue Entwicklungen in der Biologikatherapie

New developments in the field of biological pharmacotherapy

Authors

M. Geyer

¹Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der Justus-Liebig-Universität Gießen, Abteilung für Rheumatologie und klinische Immunologie, Kerckhoff-Klinik, Bad Nauheim
W. Hermann

¹Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der Justus-Liebig-Universität Gießen, Abteilung für Rheumatologie und klinische Immunologie, Kerckhoff-Klinik, Bad Nauheim
U. Müller-Ladner

¹Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der Justus-Liebig-Universität Gießen, Abteilung für Rheumatologie und klinische Immunologie, Kerckhoff-Klinik, Bad Nauheim

Abstract

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Zusammenfassung

Der Erkenntniszugewinn im Verständnis für die Pathophysiologie vieler entzündlich-rheumatischer Erkrankungen hat auch die Entwicklung neuer Pharmaka nach sich gezogen. Besonders die Fortschritte auf dem Gebiet der Biologika haben dazu beigetragen, den Lei-densdruck betroffener Patienten zu verringern und die Lebensqualität zu verbessern. Aller-dings weisen selbst diese effektiven Substanzen ein in der Nutzen-Risiko-Abwägung zwar akzeptables, dennoch aber in der klinischen Anwendung bedeutsames Nebenwirkungsprofil auf – und sie helfen nicht in jedem Fall. Es bleibt daher das Bestreben, anhand von neuen oder spezifischeren Angriffspunkten Medikamente mit geringeren Nebenwirkungsprofilen und vereinfachten Applikationsmodalitäten in größeren Intervallen mit dem Ziel einer schnelleren Remissionsindukti-on und -erhaltung zu finden und zu etablieren. Im Zuge dieser Bemühungen haben sich mehrere Agenzien herauskristallisiert, die auf die Ausweitung des medikamentösen Arsenals hoffen lassen. Einige dieser Substanzen werden auf der Grundlage aktueller Studienveröffentlichungen kurz vorgestellt. Sie sind sowohl Teil bestehender Strategien wie der TNF-Blockade, betreffen aber auch die Neutralisation neuer Zytokine und die B- und T-Zell-Biologie.

Summary

The increasing knowledge in the understanding of pathophysiological characteristics in different inflammatory conditions paved the way for the development of new pharmacological agents. Particularly, the advances in the field of biological therapy facilitated to reduce the burden of disease for the affected individuals and to ameliorate their quality of life. Considering the risk-benefit analysis, however, even these effective substances show an indeed acceptable but still not negligible profile of side effects, and they do not help in any case. Therefore, the ambition remains to further optimise the modalities of medication by means of reduced side effects and simplified application with expanded intervals to aim at an accelerated induction and sustainment of remission. Concomitantly with these efforts several agents turned out to be expected to broaden the pharmacological armamentarium. Based on recently published clinical trials some of these agents will be presented in their review. They form not only part of established strategies such as TNF inhibition but are as well related to neutralisation of novel cytokines and to the biology of B- and T-cells.

Schlüsselwörter

Pharmaka - Pathophysiologie - Zytokine - Lymphozyten

Keywords

Pharmacological - pathophysiologic - cytokines - lymphocytes

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References

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