アブストラクト
Japanese
| Title | 血管炎診療における分子標的薬 |
|---|---|
| Subtitle | 総説 |
| Authors | 佐田憲映1) |
| Authors (kana) | |
| Organization | 1)岡山大学大学院医歯薬学総合研究科腎・免疫・内分泌代謝内科学 |
| Journal | 日本皮膚免疫アレルギー学会雑誌 |
| Volume | 3 |
| Number | 2 |
| Page | 279-281 |
| Year/Month | 2020 / 4 |
| Article | 報告 |
| Publisher | 日本皮膚免疫アレルギー学会 |
| Abstract | 「要旨」原発性血管炎は, 主たる罹患血管のサイズで分類され, 大型血管炎には高安動脈炎, 巨細胞性動脈炎, 小型血管炎のうち免疫複合体が関与しないものにはANCA関連血管炎が分類される. 大型血管炎に対しては, おもに副腎皮質ステロイド薬を中心として再燃例や治療抵抗例にはさまざまな免疫抑制剤の併用が試みられてきた. 最近, 抗IL-6受容体抗体製剤トシリズマブの有用性を評価したランダム化比較試験の結果が相次いで報告された. GiACTA試験は, 巨細胞性動脈炎患者を対象とし, ステロイドフリーの状態での寛解維持効果が証明された. TAKT試験は, 治療抵抗性の高安動脈炎患者において再燃抑制効果が示唆されている. ANCA関連血管炎では, 従来治療の代替療法として抗CD20抗体製剤リツキシマブの有効性が報告されている. さらに最近では, 補体C5a受容体阻害剤アバコパンが副腎皮質ステロイド薬の代替役として, または大幅な減量が可能となる薬剤として期待されている. |
| Practice | 臨床医学：内科系 |
| Keywords | 高安動脈炎, 巨細胞性動脈炎, ANCA関連血管炎, トシリズマブ, リツキシマブ, アバコパン, Takayasu arteritis, giant cell arteritis, ANCA associated vasculitis, tocilizumab, rituximab, avacopan |
English
| Title | Biologics for Vasculitis |
|---|---|
| Subtitle | Review |
| Authors | Ken-Ei SADA1) |
| Authors (kana) | |
| Organization | 1)Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences |
| Journal | Nihon Hifu Meneki Arerugi Gakkai Zasshi |
| Volume | 3 |
| Number | 2 |
| Page | 279-281 |
| Year/Month | 2020 / 4 |
| Article | Report |
| Publisher | The Japanese Society for Cutaneous Immunology and Allergy |
| Abstract | Primary vasculitis is classified according to vessel size in 2012 revised international Chapel Hill consensus conference nomenclature: Takayasu arteritis (TAK) and giant cell arteritis (GCA) were classified into large vessel vasculitis (LVV) and ANCA associated vasculitis (AAV) were classified as small vessel vasculitis different from immune complex related vasculitis. LVV has been treated with glucocorticoids (GCs) and various immunosuppressants, but they are often refractory. Recently, some studies reported the efficacy of interleukin-6-receptor inhibitor, tocilizumab (TCZ), for LVV. GiACTA study showed that the efficacy of remission maintenance in GCA patients without GCs, while TAKT study reported the efficacy of the prevention of relapse in the refractory TAK patients. For AAV, rituximab is emerged as the alternative option to cyclophosphamide and azathioprine for remission induction and maintenance treatments. Additionally, recent report suggested GCs sparing effect of C5a receptor inhibitor, avacopan. |
| Practice | Clinical internal medicine |
| Keywords | Takayasu arteritis, giant cell arteritis, ANCA associated vasculitis, tocilizumab, rituximab, avacopan |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
参考文献
- 1) Jennette J, Falk R, Bacon P, et al: 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides, Arthritis Rheum, 65:1-11, 2013 PubMed PMID: 23045170. Epub 2012/10/10. Eng.
- 2) Stone JH Tuckwell K, Dimonaco S, et al: Trial of Tocilizumab in Giant-Cell Arteritis, N Engl J Med, 377:317-328,2017
- 3) Nakaoka Y, Isobe M, Takei S, et al: Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: results from a randomised double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study), Ann Rheum Dis, 77:348-354,2018
- 4) Sada KE, Yamamura M, Harigai M, et al: Classification and characteristics of Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study, Arthritis Res Ther, 16:R101, 2014. PubMed PMID:24758294.
- 5) Sada KE, Yamamura M, Harigai M, et al: Different responses to treatment across classified diseases and severities in Japanese patients with microscopic polyangiitis and granulomatosis with polyangiitis: a nationwide prospective inception cohort study, Arthritis Res Ther, 17:305,2015
残りの2件を表示する
- 6) 有村義宏, 丸山彰一, 本間 栄, 編: ANCA 関連血管炎診療ガイドライン 2017, 診断と治療社, 2017
- 7) Jayne DR, Bruchfeld AN, Harper L, et al: Randomized Trial of C5a Receptor Inhibitor Avacopan in ANCA-Associated Vasculitis, J Am Soc Nephrol, 28:2756-2767,2017
