乾癬性關節炎治療之新發展

New Pharmacological Treatment in Psoriatic Arthritis

邵時傑(Shih-Chieh Shao) ； 楊宗翰(Chung-Han Yang) ； 陳玉瑩(Yuk-Ying Chan)

《醫學與健康期刊》 5卷2期 (2016/09) Pp. 95-102

摘要

乾癬性關節炎(psoriatic arthritis)是一種與乾癬相關的慢性發炎關節病變，病人必須接受治療才能避免疾病造成的中軸和周邊關節破壞。目前常用藥物包含非類固醇抗發炎藥物和疾病修飾劑(disease-modifying antirheumatic drugs, DMARDs)。隨著對致病機轉的瞭解與基因工程的進步，各種針對特定目標分子的藥物也相繼問世。口服磷酸雙酯酶4(phosphodiesterase 4, PDE4)抑制劑，用於治療成人活動性乾癬性關節炎。臨床試驗顯示，透過調控體內發炎反應，apremilast可顯著增加病人在治療16周後達到20％美國風濕病醫學會反應率(American College of Rheumatology, ACR20)的比率、改善52周後關節腫脹數及疼痛數和增進生活品質。Apremilast已於2014年3月經美國食品藥物管理局核准上市，本文將簡介該藥的藥理特性與相關臨床試驗結果，供臨床醫療人員參考。

關鍵字

乾癬性關節炎 ； 磷酸雙酯酶4抑制劑

並列摘要

Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis. People with this disease must receive effective treatment to avoid deterioration of the axial and peripheral joints. Currently, non-steroid anti-inflammatory drugs and disease-modifying antirheumatic drugs (DMARDs) are commonly used for the treatment of PsA. However, recent advances in biological engineering and greater understanding of the pathogenesis of this disease have enabled the development of new drugs to treat PsA. Oral phosphodiesterase 4 (PDE4) inhibitor is applied to the treatment of active PsA in adults. Apremilast, through its modulation of inflammatory responses, has been found in clinical to confer 20% improvement in response criteria listed by modified American College of Rheumatology (ACR) response criteria at week 16 compared to baseline. Improvements in counts of swollen and tender joints and quality of life were achieved at week 52. Apremilast was approved by the US FDA in March 2014. This article provides health professionals with concise information about the pharmacological action and the results of clinical trials.

並列關鍵字

Psoriatic arthritis ； Phosphodiesterase 4 inhibitor

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