患有多发性硬化症和结性脊柱炎的患者的生物治疗:基于病例的综述
Iva Žagar1,2, Marita Babić1, Kristina Kovač Durmiš1,2
1Clinic for Rheumatic Diseases and Rehabilitation, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.
Rheumatology international
|September 29, 2025
概括
干白素-17 (IL-17) 抑制剂,如seukinumab,在患有多发性硬化症 (MS) 的患者中提供结性脊髓炎 (AS) 的有效治疗方法. 这种方法避免了瘤缩因子-α (TNF-α) 抑制剂,在MS中禁用.
科学领域:
- 类风湿病学 类风湿病学
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 多发性硬化症 (MS) 和结性脊髓炎 (AS) 的同时存在是罕见的.
- 无论是MS还是AS都是渐进的疾病,往往需要生物治疗.
- 瘤坏死因子-α (TNF-α) 抑制剂是AS的第一线生物药物,但由于脱髓化风险,在MS中禁用.
研究的目的:
- 评估IL-17抑制剂在患有先前多发性硬化症的患者中治疗AS的疗效和安全性.
- 解决当TNF-α抑制剂禁用时选择适当的生物疗法所面临的临床挑战.
主要方法:
- 一名患有MS和AS的患者接受了针对AS的IL-17抑制剂secukinumab的治疗.
- 治疗决定是在与神经病学家协商后做出的.
- 临床改善的评估是使用浴化脊柱炎疾病活动指数 (BASDAI).
主要成果:
- 塞库金纽马布治疗导致AS症状显著减少,包括疼痛和早晨硬.
- 在治疗6个月后,BASDAI评分从5.3降至2.95.
- 在患有AS的MS患者中,IL-17抑制被证明是TNF-α抑制剂的潜在更安全的替代品.
结论:
- IL-17抑制剂,特别是seukinumab,可以成为患有多发性硬化症的患者结性脊髓炎的有效和更安全的生物治疗选择.
- 这个案例突出了一个成功的治疗策略,在复杂的并发症条件下,应对AS标准治疗的禁忌.
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