僵直性脊椎關節炎及乾癬性關節炎免疫生物製劑治療之新進展

Biological Agents for the Treatment of Ankylosing Spondylitis and Psoriatic Arthritis

僵直性脊椎炎（ankylosing spondylitis）和乾癬性關節炎（psoriatic arthritis）都是一種慢性發炎性之脊椎關節的疾病（spondyloarthritis）。有效的治療和控制這些疾病，避免它們造成患者的脊椎和周邊關節的破壞是治療目標。隨著免疫學及基因工程的進步，使各種針對特定目標分子的生物製劑相繼發明。基本上可分為抗腫瘤壞死因子製劑（etanercept, adalimumab, golimumab 等）、非抗腫瘤壞死因子製劑（abatacept, alefacept, secukinumab, ustekinumab 等）和小分子口服標靶藥物（tofacitinib, apremilast 等）。將來醫師在治療僵直性脊椎炎、乾癬和乾癬性關節炎會有更多的選擇及不錯的效果。

Ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are subtype of spondyloarthritis. The primary goal of therapy is to hamper the destruction of joints and maximize the preservation of physical function. Moreover, the improvement of biological engineering and understanding of the pathogenesis of both diseases had enabled the development of new biological agents to treat the diseases. The biological agents can be classified in three categories: 1. anti-tumor necrosis-alpha group (etanercept, adalimumab, golimumab etc.), 2. non-anti-tumor necrosis-alpha group (abatacept, alefacept, secukinumab, ustekinumab etc.), 3. small molecules target therapy (tofacitinib, apremilast etc.). The treatment for ankylosing spondylitis and psoriatic arthritis in future is optimistic with drugs that are more effective and less side effects.