{"id":23540,"date":"2016-01-29T00:28:48","date_gmt":"2016-01-28T16:28:48","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=23540"},"modified":"2018-08-01T16:48:19","modified_gmt":"2018-08-01T08:48:19","slug":"%e3%80%90%e5%85%8d%e7%96%ab%e9%86%ab%e5%ad%b8%e3%80%912015%e5%b9%b4%e6%96%b0%e8%97%a5%e7%99%bc%e5%b1%95%e6%88%b2%e5%8a%87%e7%8e%8b%ef%bc%9abrodalumab","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=23540","title":{"rendered":"\u3010\u514d\u75ab\u91ab\u5b78\u30112015\u5e74\u65b0\u85e5\u767c\u5c55\u6232\u5287\u738b\uff1aBrodalumab"},"content":{"rendered":"

\u25a0\u4eca\u5929\u4f86\u8ac7\u8ac7\u6cbb\u7642\u4e7e\u766c\u8207\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\u7684\u65b0\u85e5Brodalumab\uff0c\u5728\u65b0\u85e5\u8a66\u9a57\u88e1\u7684\u6232\u5287\u5316\u767c\u5c55\u53f2\uff01<\/strong><\/span><\/p>\n

\"photo:european
photo:european pharmaceutical review<\/figcaption><\/figure>\n

\u64b0\u6587\uff5c<\/strong>\u99f1\u5b9b\u7433<\/p>\n

Brodalumab\u662f\u4e00\u682a\u4eba\u985e\u514d\u75ab\u7403\u86cb\u767d\u55ae\u682a\u6297\u9ad4\uff0c\u53ef\u4ee5\u4f5c\u70ba\u514d\u75ab\u6291\u5236\u5291\uff0c\u65b0\u85e5\u767c\u5c55\u7684\u76ee\u6a19\u662f\u6cbb\u7642\u4e7e\u766c\uff08Psoriasis\uff1b\u53c8\u7a31\u4f5c\u725b\u76ae\u766c\uff09\u8207\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\uff08Psoriasis arthritis\uff09\u3002\u4e7e\u766c\u8207\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\u662f\u56e0\u70ba\u514d\u75ab\u7cfb\u7d71\u5931\u8abf\u6240\u5f15\u8d77\u7684\u6162\u6027\u767c\u708e\u75be\u75c5\uff0c\u4f46\u548c\u5176\u4ed6\u5927\u90e8\u5206\u7684\u81ea\u9ad4\u514d\u75ab\u75be\u75c5\u4e0d\u540c\u7684\u662f\uff0c\u60a3\u8005\u8840\u6e05\u5167\u4e26\u6c92\u6709\u6703\u653b\u64ca\u81ea\u8eab\u7d30\u80de\u7684\u81ea\u9ad4\u6297\u9ad4\u3002<\/p>\n

\u4e7e\u766c\u8207\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\u96d6\u7136\u75c5\u7406\u7279\u5fb5\u8207\u81e8\u5e8a\u75c7\u72c0\u4e0d\u76e1\u76f8\u540c\uff0c\u4f46\u5169\u7a2e\u75be\u75c5\u7684\u75c5\u7406\u6a5f\u5236\u90fd\u727d\u6d89\u5230\u540c\u4e00\u7a2e\u514d\u75ab\u7d30\u80de\uff1a\u8f14\u52a9\u578bT\u7d30\u80de\uff08T helper cells\uff09\uff0c\u5c24\u5176\u662f\u5176\u4e2d\u7684\u7b2c\u5341\u4e03\u8f14\u52a9\u578bT\u7d30\u80de \uff08T helper 17 cells\uff0c\u5e38\u7c21\u5beb\u505aTh17\uff09\u3002Th17\u7d30\u80de\u5728\u8a31\u591a\u81ea\u9ad4\u514d\u75ab\u75be\u75c5\u88e1\u9762\u90fd\u626e\u6f14\u8457\u95dc\u9375\u89d2\u8272\uff0c\u9664\u4e86\u4e7e\u766c\uff0c\u9084\u6709\u985e\u98a8\u6fd5\u6027\u95dc\u7bc0\u708e\u3001\u6c23\u5598\u3001\u591a\u767c\u6027\u786c\u5316\u75c7\u7b49\u3002<\/p>\n

\u521d\u59cb\u8f14\u52a9\u578bT\u7d30\u80de\uff08naive T helper cells\uff09\u50cf\u662fT\u7d30\u80de\u88e1\u7684\u751f\u529b\u8ecd\uff0c\u7576\u9ad4\u5167\u7d44\u7e54\u88e1\u6709\u767c\u708e\u53cd\u61c9\u767c\u751f\u7684\u6642\u5019\uff0c\u6703\u6839\u64da\u74b0\u5883\u88e1\u4e0d\u540c\u7684\u60c5\u6cc1\u5206\u5316\u6210\u4e0d\u540c\u7684T\u7d30\u80de\u4e9e\u7fa4\u3002\u4f8b\u5982\uff0c\u5728\u4e7e\u766c\u7684\u60a3\u90e8\uff0c\u5e38\u805a\u96c6\u4e86\u8a31\u591a\u6a39\u7a81\u7d30\u80de\uff0c\u6703\u5206\u6ccc\u5927\u91cf\u7684TGF\u03b2\u3001IL6\u8ddfIL23\u7b49\u7d30\u80de\u6fc0\u7d20\u3002\u9019\u4e9b\u7d30\u80de\u6fc0\u7d20\u50cf\u662f\u70baTh17\u7d30\u80de\u91cf\u8eab\u8a02\u505a\u7684\u5f7c\u5f97\u6f58\u91d1\u7c89\u4e00\u6a23\uff0c\u521d\u59cbT\u7d30\u80de\u5728\u6709TGF\u03b2\u3001IL6\u8ddfIL23\u7684\u74b0\u5883\u4e0b\uff0c\u5c31\u6703\u5206\u5316\u70baTh17\u7d30\u80de\u3002\u5c24\u5176\u662fIL23\uff0c\u66f4\u662fTh17\u7d30\u80de\u5206\u5316\u904e\u7a0b\u4e2d\u6700\u4e0d\u53ef\u6216\u7f3a\u7684\u8981\u89d2\u3002Th17\u7d30\u80de\u7684\u5176\u4e2d\u4e00\u500b\u7279\u9ede\uff0c\u5c31\u662f\u6703\u88fd\u9020IL17\u7d30\u80de\u6fc0\u7d20\uff0c\u800c\u4e14\u4e5f\u662f\u56e0\u6b64\u800c\u5f97\u540d\u3002\u4f46\u8a0e\u53ad\u7684\u662f\uff0cIL17\u50cf\u662f\u767c\u708e\u53cd\u61c9\u7684\u871c\u7cd6\uff0c\u6703\u5f15\u4f86\u55dc\u4e2d\u6027\u767d\u8840\u7403\u3001\u55ae\u6838\u7403\u7b49\u514d\u75ab\u7d30\u80de\uff0c\u4fc3\u9032\u767c\u708e\u53cd\u61c9\u800c\u9020\u6210\u6301\u4e45\u6027\u7d44\u7e54\u50b7\u5bb3\u3002\u56e0\u6b64\uff0cIL23\/Th17\/IL17\u9019\u4e09\u500b\u6392\u6392\u7ad9\u3001\u9023\u9396\u5982\u9aa8\u724c\u6548\u61c9\u7684\u50a2\u4f19\uff0c\u5728\u91dd\u5c0d\u4e7e\u766c\u3001\u6c23\u5598\u6216\u5176\u4ed6\u81ea\u9ad4\u514d\u75ab\u75be\u75c5\u7684\u65b0\u85e5\u7814\u767c\u88e1\uff0c\u4e00\u76f4\u90fd\u662f\u85e5\u5ee0\u6c42\u4e4b\u4e0d\u5f97\u7684\u901a\u7ddd\u72af\u3002\u800cBrodalumab\u9019\u682a\u55ae\u682a\u6297\u9ad4\uff0c\u5c31\u662f\u5c07\u7832\u706b\u96c6\u4e2d\u653b\u64caIL17\u53d7\u5668\uff0c\u4f86\u963b\u65b7IL17\u7d30\u80de\u6fc0\u7d20\u7d50\u5408\u4e0aIL17\u53d7\u5668\uff0c\u65bc\u662fIL17\u5c31\u7121\u6cd5\u6d3b\u5316\u8207\u523a\u6fc0\u4e0b\u6e38\u53cd\u61c9\u3002\"MECHANISM<\/p>\n

Brodalumab\u662f\u5169\u5927\u77e5\u540d\u85e5\u5ee0Amgen\u8ddfAstraZeneca\u6240\u5171\u540c\u958b\u767c\uff0c\u57282012\u5e74\u9032\u5165\u7b2c\u4e09\u671f\u81e8\u5e8a\u8a66\u9a57\u4ee5\u4f86\uff0c\u4e00\u76f4\u662f\u773e\u6240\u77da\u76ee\u7684\u7126\u9ede\u30022015\u5e74\u4e94\u6708\u5e95\uff0c\u70ba\u671f\u4e09\u5e74\u7684\u81e8\u5e8a\u8a66\u9a57\u773c\u770b\u5c31\u8981\u4fee\u6210\u6b63\u679c\uff0c\u5404\u754c\u4e5f\u90fd\u5f15\u9838\u671f\u76fc\u8a66\u9a57\u7d50\u679c\u7684\u597d\u6d88\u606f\u3002\u4f46\u7576\u5927\u5bb6\u7684\u5fc3\u65e9\u5df2\u98db\u5230\u7f8e\u570b\u570b\u6ba4\u7d00\u5ff5\u65e5\u7684\u9577\u9031\u672b\u5047\u671f\u6642\uff0cAmgen\u7a81\u7136\u767c\u8868\u8072\u660e\uff0c\u8868\u793a\u8981\u5f9eBrodalumab\u7684\u65b0\u85e5\u7814\u7a76\u4e2d\u62bd\u624b\u3002\u539f\u56e0\u662f\u5728\u7b2c\u4e09\u671f\u81e8\u5e8a\u8a66\u9a57\u88e1\uff0c\u6709\u53d7\u8a66\u8005\u8d77\u5fc3\u52d5\u5ff5\u60f3\u8981\u81ea\u6bba\uff0c\u4e26\u4e14\u4e0d\u5e78\u7684\u662f\uff0c\u5176\u4e2d\u6709\u53d7\u8a66\u8005\u78ba\u5b9a\u56e0\u81ea\u6bba\u800c\u6b7b\u4ea1\u3002\u5728\u9019\u7a2e\u614b\u52e2\u4e0b\uff0cAmgen\u64d4\u5fc3\u7f8e\u570b\u98df\u54c1\u66a8\u85e5\u7269\u7ba1\u7406\u5c40\u5728\u6838\u51c6Brodalumab\u4e0a\u5e02\u4e4b\u5f8c\uff0c\u6703\u8981\u6c42\u85e5\u5ee0\u5728\u85e5\u54c1\u4eff\u55ae\u4e0a\u52a0\u8a3b\u8b66\u8a9e\uff0c\u63d0\u9192\u91ab\u751f\u60a3\u8005\u5728\u670d\u85e5\u5f8c\u53ef\u80fd\u6703\u589e\u52a0\u81ea\u6bba\u98a8\u96aa\uff0c\u56e0\u800c\u6c7a\u5b9a\u5f9e\u5408\u4f5c\u6848\u4e2d\u9000\u5834\u3002<\/p>\n

\u4e7e\u766c\u75c7\u60a3\u8005\u88e1\uff0c\u6709\u5f88\u5927\u4e00\u90e8\u4efd\u7684\u75c5\u4eba\u53d7\u6182\u9b31\u6240\u64fe\u3002\u7f8e\u570b\u570b\u5bb6\u4e7e\u766c\u57fa\u91d1\u6703\uff08National Psoriasis Foundation\uff09\u5c07\u6182\u9b31\u75c7\u5217\u70ba\u5728\u4e7e\u766c\u60a3\u8005\u8eab\u4e0a\u6700\u666e\u904d\u88ab\u540c\u6642\u78ba\u8a3a\u7684\u75be\u75c5\uff0c\u6bd4\u4f8b\u7d04\u662f\u6c92\u6709\u7f79\u60a3\u4e7e\u766c\u60a3\u8005\u7684\u5169\u500d\u3002\u81e8\u5e8a\u4e0a\uff0c\u4e7e\u766c\u60a3\u8005\u4e5f\u6bd4\u8f03\u5bb9\u6613\u840c\u751f\u81ea\u6bba\u7684\u60f3\u6cd5\uff0c\u751a\u81f3\u51fa\u73fe\u81ea\u6bba\u884c\u70ba\u3002\u5982\u679cBrodalumab\u5728\u4eff\u55ae\u4e0a\u88ab\u8981\u6c42\u52a0\u8a3b\u300c\u6709\u589e\u52a0\u81ea\u6bba\u98a8\u96aa\u300d\u7684\u8b66\u8a9e\uff0c\u5c31\u6709\u53ef\u80fd\u6703\u5927\u5927\u9650\u7e2e\u4e86\u65b0\u85e5\u5e02\u5834\u3002<\/p>\n

\u525b\u6ce8\u610f\u5230Amgen\u5f9eBrodalumab\u81e8\u5e8a\u7814\u7a76\u4e2d\u9000\u51fa\u7684\u6642\u5019\uff0c\u5fc3\u88e1\u662f\u65e2\u64d4\u5fc3\u53c8\u89ba\u5f97\u597d\u53ef\u60dc\u3002\u5f9e\u7814\u7a76\u5ba4\u65e5\u4ee5\u7e7c\u591c\u88e1\u7684\u7814\u7a76\u5230\u81e8\u5e8a\u8a66\u9a57\uff0c\u662f\u6f2b\u9577\u5730\u50cf\u628a\u4e16\u754c\u4e0a\u6240\u6709\u7684\u99ac\u62c9\u677e\u90fd\u8dd1\u904e\u4e00\u8f2a\u4e00\u6a23\u3002\u800cBrodalumab\u773c\u770b\u5c31\u8981\u8dd1\u5230\u4e86\u6700\u5f8c\u4e00\u5834\u3001\u6700\u5f8c\u4e00\u54e9\u8def\uff0c\u537b\u9047\u5230\u4e86\u85e5\u5ee0\u6700\u5bb3\u6015\u7684\u4e8b\u3002\u4e0d\u904e\uff0c\u9084\u597dAstraZeneca\u6c92\u6709\u56e0\u6b64\u6253\u4e82Brodalumab\u76f8\u95dc\u7684\u6295\u8cc7\u8a08\u5283\u3002\u5728\u4e5d\u6708\u7684\u6642\u5019\uff0c\u66f4\u627e\u5230\u4e86\u53e6\u4e00\u500b\u5408\u4f5c\u5925\u4f34Valeant Pharmaceuticals\u4e00\u8d77\u4f86\u63a8\u52d5Brodalumab\u5728\u7f8e\u570b\u8207\u6b50\u6d32\u7684\u6838\u51c6\u7533\u8acb\u6848\u8207\u4e0a\u5e02\u8a08\u5283\u3002<\/p>\n

2015\u5e74\u5341\u6708\uff0cBrodalumab\u7684\u7b2c\u4e09\u968e\u6bb5\u81e8\u5e8a\u8a66\u9a57\u7684\u7d50\u679c\u767c\u8868\u5728The New England Journal of Medicine<\/em>\uff0c\u8868\u73fe\u4e5f\u5982\u9810\u671f\u822c\u4eae\u773c\u3002\u8a66\u9a57\u88e1\u6240\u63a1\u7528\u7684\u7642\u6548\u6307\u6a19\u8a55\u5224\u6a19\u6e96\u662f\u300c\u4e7e\u766c\u9762\u7a4d\u66a8\u56b4\u91cd\u5ea6\u6307\u6578\u300d\uff0c\u53c8\u7a31\u4f5cPASI\u3002\u5728\u4e2d\u5ea6\u81f3\u91cd\u5ea6\u7684\u4e7e\u766c\u60a3\u8005\u4e2d\uff0c\u7576\u7d66\u4e88Brodalumab\u5341\u4e8c\u500b\u79ae\u62dc\u4e4b\u5f8c\uff0c\u5169\u7d44\u81e8\u5e8a\u8a66\u9a57\u88e1\u90fd\u6709\u8d85\u904e\u516b\u6210\u4e94\u7684\u60a3\u8005\uff0c\u5176\u4e7e\u766c\u9762\u7a4d\u548c\u56b4\u91cd\u5ea6\u6539\u5584\u4e8675%\uff08\u5373\u9054\u5230PASI 75\uff09\uff1b\u4e26\u4e14\u5404\u6709\u7d04\u56db\u6210\u4e0a\u4e0b\u7684\u60a3\u8005\uff0c\u5728\u6295\u85e5\u5341\u4e8c\u500b\u79ae\u62dc\u4e4b\u5f8c\uff0c\u4e7e\u766c\u5b8c\u5168\u6e05\u9664\uff08PSAI 100\uff09\u3002\u800c\u4e14\uff0c\u81e8\u5e8a\u5be6\u9a57\u4e2d\u4e5f\u540c\u6642\u6db5\u62ec\u4e86\u53e6\u4e00\u682a\u5df2\u88ab\u6838\u51c6\u4e0a\u5e02\u7684\u4e7e\u766c\u7528\u85e5Ustekinumab\uff1bUstekinumab\u4ee5\u91dd\u5c0dIL23\u70ba\u4e3b\uff0c\u80fd\u5920\u7d50\u5408\u4e0aIL23\u7684\u5176\u4e2d\u4e00\u500b\u7d44\u6210\u86cb\u767d\uff0c\u800c\u8b93IL23\u5931\u53bb\u6d3b\u6027\u3002\u5728\u5169\u7d44\u81e8\u5e8a\u5be6\u9a57\u4e2d\uff0cBrodalumab\u7684\u7642\u6548\u53cd\u61c9\u5ea6\u90fd\u5e7e\u4e4e\u662fUstekinumab\u7684\u5169\u500d\uff01\u9019\u4e0d\u557b\u662f\u70ba\u7814\u767c\u8def\u4e0a\u5e7e\u7d93\u6ce2\u6298\u7684Brodalumab\u6253\u4e86\u4e00\u5291\u5f37\u5fc3\u91dd\u3002<\/p>\n

\u5982\u4eca\u5927\u534a\u5e74\u904e\u4e86\uff0cBrodalumab\u9019\u500b\u524d\u666f\u770b\u597d\uff0c\u65b0\u85e5\u8a66\u9a57\u7814\u7a76\u8207\u6295\u8cc7\u767c\u5c55\u904e\u7a0b\u537b\u53c8\u6b77\u7d93\u6ce2\u6298\u7684\u8d85\u65b0\u661f\uff0c\u7406\u6240\u7576\u7136\u7372\u5f972015\u5e74\u65b0\u85e5\u767c\u5c55\u7684\u5e74\u5ea6\u6232\u5287\u738b\uff0c\u5be6\u5728\u4e5f\u6c92\u6709\u5176\u4ed6\u65b0\u85e5\u80fd\u5920\u8ddf\u5b83\u6436\u3002\u5e0c\u671b2016\u65b0\u5e74\u65b0\u5e0c\u671b\u88e1\uff0cBrodalumab\u7684\u6838\u51c6\u7533\u8acb\u80fd\u5920\u7da0\u71c8\u4eae\u8d77\uff01\u6211\u5011\u4e00\u8d77\u4f86\u671f\u5f85Brodalumab\u7684\u597d\u6d88\u606f\u5427\uff01<\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong>
\n1. Harden JL, Krueger JG, Bowcock AM. The immunogenetics of Psoriasis: A comprehensive review. J Autoimmun. 2015 Nov;64:66-73. doi: 10.1016\/j.jaut.2015.07.008. Epub 2015 Jul 26. Review.
\n2. Marinoni B, Ceribelli A, Massarotti MS, Selmi C. The Th17 axis in psoriatic disease: pathogenetic and therapeutic implications. Auto Immun Highlights. 2014 Jan 22;5(1):9-19. doi: 10.1007\/s13317-013-0057-4. eCollection 2014 Jun. Review.
\n3. Lebwohl M, Strober B, Menter A, Gordon K, Weglowska J, Puig L, Papp K, Spelman L, Toth D, Kerdel F, Armstrong AW, Stingl G, Kimball AB, Bachelez H, Wu JJ, Crowley J, Langley RG, Blicharski T, Paul C, Lacour JP, Tyring S, Kircik L, Chimenti S, Callis Duffin K, Bagel J, Koo J, Aras G, Li J, Song W, Milmont CE, Shi Y, Erondu N, Klekotka P, Kotzin B, Nirula A. Phase 3 Studies Comparing Brodalumab with Ustekinumab in Psoriasis. N Engl J Med. 2015 Oct;373(14):1318-28. doi: 10.1056\/NEJMoa1503824.
\n4. Danesh MJ, Kimball AB. Brodalumab and suicidal ideation in the context of a recent economic crisis in the United States. J Am Acad Dermatol. 2016 Jan;74(1):190-2. doi: 10.1016\/j.jaad.2015.08.057. No abstract available.<\/p>\n

--<\/span><\/strong>
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