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*Only for medical professionals to read for reference.
The treatment of ankylosing spondylitis has entered a new "interleukin" era.
With the emergence of new drugs and the continuous updating of treatment methods, the treatment of ankylosing spondylitis (AS) has undergone a transition from the era of traditional drugs to the era of biological agents.
In 2015, the European Medicines Agency approved the interleukin (IL)-17A inhibitor scocilizumab for the treatment of AS; on April 28, 2020, scocilizumab was approved for AS indications in China, and the treatment of AS in my country This entered the "interleukin era".
Today, Skuchi Yumab has been commercially listed in China for its first anniversary.
What kind of changes has it brought about in the field of AS treatment, and what benefits has it brought to patients? We specially invited Professor Li Mengtao, deputy director of the Department of Rheumatology and Immunology, Peking Union Medical College Hospital, to discuss this issue and spread authoritative voices.
Click on the video to view Professor Li Mengtao’s wonderful views 1 Management of AS requires a long-term perspective.
Professor Li Mengtao said that AS is an autoimmune disease with a high disability rate.
The progression of the disease is likely to cause damage and destruction of the patient’s bone structure.
Cause dysfunction.
Therefore, for the long-term management of diseases, we must use a developmental perspective.
Not only to control symptoms, that is, analgesia, but also to pay attention to anti-inflammatory treatment.
As a doctor, we have to look farther and let patients realize that changes in bone structure such as rigidity caused by the disease will significantly affect the prognosis, which is the most harmful to patients.
The so-called developmental vision should be from analgesia, anti-inflammatory, to the long-term inhibition of new bone formation and prevention of rigidity, so that the patient's quality of life and work ability can be maintained very well.
2 New progress: Drug advancement promotes the whole course of disease management.
Although both belong to rheumatoid diseases, the pathogenesis of AS is different from rheumatoid arthritis (RA).
RA is mainly due to bone destruction caused by inflammation, and AS has other characteristics— -In addition to bone destruction caused by inflammation, there is also the formation of new bone, so its mechanism is more special.
In the past, the treatment of AS started with non-steroidal anti-inflammatory drugs (NSAIDs), which can relieve pain and have weak anti-inflammatory capabilities.
The emergence of biological agents started the era of targeted therapy, with tumor necrosis factor inhibitors (TNFi) with stronger anti-inflammatory effects.
But at present, neither NSAIDs nor TNFi have good effects on new bone formation and changes in bone structure.
In the past year or two, gratifying progress has been made, that is, AS treatment has entered the "interleukin era".
The emergence of IL-17A inhibitors represented by Skucilumab provides patients with a new treatment plan, which not only can anti-inflammatory, but also has the effect of long-term inhibition of new bone formation.
Since then, the clinical treatment of AS has begun the whole process of disease management from simple analgesia and anti-inflammatory to long-term bone suppression.
3IL-17A inhibitors promote the guideline update Professor Li Mengtao introduced that the AS diagnosis and treatment guidelines of the Taiwan Rheumatology Association of China [1] pointed out that such diseases are still in the stage of lack of therapeutic drugs, especially when compared with RA, the drugs are very limited.
The basic drugs in the guidelines are NSAIDs, and their limited anti-inflammatory effects can help some patients with mild symptoms and slow progression of the disease to control their clinical symptoms.
The further medication is TNFi, which has a strong anti-inflammatory effect.
The guidelines mention that if NSAIDs do not control the patient's clinical symptoms well, TNFi should be actively added.
For the treatment of AS, the previous guidelines only have these two types of drugs.
Their effects are limited to anti-inflammatory and analgesic and symptom improvement, but they have no significant effect on new bone formation and bone destruction caused by the disease.Now, according to the latest research progress, the era of interleukins in AS treatment has arrived.
The treatment goals in the guidelines have changed from short-term improvement of patient symptoms and anti-inflammatory analgesia to long-term inhibition of new bone formation and maintenance of function.
A large amount of evidence-based medical evidence confirms that IL-17A inhibitor drugs targeting IL-12/23/17 pathway, represented by Skuchiyuumab, can simultaneously achieve the therapeutic effects of anti-inflammatory and analgesic and inhibiting the formation of new bone , To achieve full management of patients.
Therefore, this kind of drugs that were placed in the third-line treatment at the beginning of the entry guidelines have now been listed alongside TNFi in some regional guidelines and the literature of authoritative journals, and they are both second-line treatments [1-2].
In the future, IL-17A inhibitors that can not only improve symptoms, but also improve the quality of life at the same time, are expected to benefit more AS patients and help them achieve a better life.
References: [1]Wei JC,et al.
Int J Rheum Dis.
2020 Jan; 23(1)7-23.
[2]Sieper J,et al.
Lancet.
2017 Jul 1; 390(10089):73- 84.
Expert profile Prof.
Li Mengtao, Professor of Department of Rheumatology and Immunology, Peking Union Medical College Hospital, doctoral student/clinical post-doctoral tutor, Distinguished Professor of Union Scholars, Deputy Director of Department, Chairman of Rheumatology Branch of Beijing Medical Association, Vice Chairman of Rheumatology Branch of Chinese Medical Association, Chinese Physician Vice President of the Association of Rheumatology and Immunologists and Leader of the Pulmonary Vascular/Interstitial Diseases Group Member of the Asia-Pacific Alliance against Rheumatism (APLAR) Systemic Lupus Erythematosus Research Group Member of the Asia-Pacific Systemic Lupus Erythematosus Collaborative Group (APLC) Member of China Systemic Lupus Lupus Research Collaboration Group (CSTAR), National Rheumatism Data Center (CRDC), China Rheumatology and Immunology Medical Association (CRCA), National Center for Clinical Research on Skin and Immune Diseases (NCRC-DID) Secretary General of the 13th Five-Year Plan Research and development plan, the project leader of the capital collaborative innovation key project systemic lupus erythematosus spoke on behalf of the team 30 times at international conferences, published 55 SCI articles as the first/corresponding author, and won the CRA/EAGOR/APLAR/EULAR Young Researcher Award Periodic review of the changes in the treatment of ankylosing spondylitis: from "symptomatic treatment" to "overall management", the new medical insurance catalogue is officially implemented.
What changes will it bring to the diagnosis and treatment of AS? The latest medical insurance drug list is implemented, IL-17A inhibitors will benefit more rigid patients! "Inflammation" must be lost, and anti-inflammatory methods: The relationship between IL-17A and inflammation is explored.
What is the relationship between IL-17A and the pain of ankylosing spondylitis?
The treatment of ankylosing spondylitis has entered a new "interleukin" era.
With the emergence of new drugs and the continuous updating of treatment methods, the treatment of ankylosing spondylitis (AS) has undergone a transition from the era of traditional drugs to the era of biological agents.
In 2015, the European Medicines Agency approved the interleukin (IL)-17A inhibitor scocilizumab for the treatment of AS; on April 28, 2020, scocilizumab was approved for AS indications in China, and the treatment of AS in my country This entered the "interleukin era".
Today, Skuchi Yumab has been commercially listed in China for its first anniversary.
What kind of changes has it brought about in the field of AS treatment, and what benefits has it brought to patients? We specially invited Professor Li Mengtao, deputy director of the Department of Rheumatology and Immunology, Peking Union Medical College Hospital, to discuss this issue and spread authoritative voices.
Click on the video to view Professor Li Mengtao’s wonderful views 1 Management of AS requires a long-term perspective.
Professor Li Mengtao said that AS is an autoimmune disease with a high disability rate.
The progression of the disease is likely to cause damage and destruction of the patient’s bone structure.
Cause dysfunction.
Therefore, for the long-term management of diseases, we must use a developmental perspective.
Not only to control symptoms, that is, analgesia, but also to pay attention to anti-inflammatory treatment.
As a doctor, we have to look farther and let patients realize that changes in bone structure such as rigidity caused by the disease will significantly affect the prognosis, which is the most harmful to patients.
The so-called developmental vision should be from analgesia, anti-inflammatory, to the long-term inhibition of new bone formation and prevention of rigidity, so that the patient's quality of life and work ability can be maintained very well.
2 New progress: Drug advancement promotes the whole course of disease management.
Although both belong to rheumatoid diseases, the pathogenesis of AS is different from rheumatoid arthritis (RA).
RA is mainly due to bone destruction caused by inflammation, and AS has other characteristics— -In addition to bone destruction caused by inflammation, there is also the formation of new bone, so its mechanism is more special.
In the past, the treatment of AS started with non-steroidal anti-inflammatory drugs (NSAIDs), which can relieve pain and have weak anti-inflammatory capabilities.
The emergence of biological agents started the era of targeted therapy, with tumor necrosis factor inhibitors (TNFi) with stronger anti-inflammatory effects.
But at present, neither NSAIDs nor TNFi have good effects on new bone formation and changes in bone structure.
In the past year or two, gratifying progress has been made, that is, AS treatment has entered the "interleukin era".
The emergence of IL-17A inhibitors represented by Skucilumab provides patients with a new treatment plan, which not only can anti-inflammatory, but also has the effect of long-term inhibition of new bone formation.
Since then, the clinical treatment of AS has begun the whole process of disease management from simple analgesia and anti-inflammatory to long-term bone suppression.
3IL-17A inhibitors promote the guideline update Professor Li Mengtao introduced that the AS diagnosis and treatment guidelines of the Taiwan Rheumatology Association of China [1] pointed out that such diseases are still in the stage of lack of therapeutic drugs, especially when compared with RA, the drugs are very limited.
The basic drugs in the guidelines are NSAIDs, and their limited anti-inflammatory effects can help some patients with mild symptoms and slow progression of the disease to control their clinical symptoms.
The further medication is TNFi, which has a strong anti-inflammatory effect.
The guidelines mention that if NSAIDs do not control the patient's clinical symptoms well, TNFi should be actively added.
For the treatment of AS, the previous guidelines only have these two types of drugs.
Their effects are limited to anti-inflammatory and analgesic and symptom improvement, but they have no significant effect on new bone formation and bone destruction caused by the disease.Now, according to the latest research progress, the era of interleukins in AS treatment has arrived.
The treatment goals in the guidelines have changed from short-term improvement of patient symptoms and anti-inflammatory analgesia to long-term inhibition of new bone formation and maintenance of function.
A large amount of evidence-based medical evidence confirms that IL-17A inhibitor drugs targeting IL-12/23/17 pathway, represented by Skuchiyuumab, can simultaneously achieve the therapeutic effects of anti-inflammatory and analgesic and inhibiting the formation of new bone , To achieve full management of patients.
Therefore, this kind of drugs that were placed in the third-line treatment at the beginning of the entry guidelines have now been listed alongside TNFi in some regional guidelines and the literature of authoritative journals, and they are both second-line treatments [1-2].
In the future, IL-17A inhibitors that can not only improve symptoms, but also improve the quality of life at the same time, are expected to benefit more AS patients and help them achieve a better life.
References: [1]Wei JC,et al.
Int J Rheum Dis.
2020 Jan; 23(1)7-23.
[2]Sieper J,et al.
Lancet.
2017 Jul 1; 390(10089):73- 84.
Expert profile Prof.
Li Mengtao, Professor of Department of Rheumatology and Immunology, Peking Union Medical College Hospital, doctoral student/clinical post-doctoral tutor, Distinguished Professor of Union Scholars, Deputy Director of Department, Chairman of Rheumatology Branch of Beijing Medical Association, Vice Chairman of Rheumatology Branch of Chinese Medical Association, Chinese Physician Vice President of the Association of Rheumatology and Immunologists and Leader of the Pulmonary Vascular/Interstitial Diseases Group Member of the Asia-Pacific Alliance against Rheumatism (APLAR) Systemic Lupus Erythematosus Research Group Member of the Asia-Pacific Systemic Lupus Erythematosus Collaborative Group (APLC) Member of China Systemic Lupus Lupus Research Collaboration Group (CSTAR), National Rheumatism Data Center (CRDC), China Rheumatology and Immunology Medical Association (CRCA), National Center for Clinical Research on Skin and Immune Diseases (NCRC-DID) Secretary General of the 13th Five-Year Plan Research and development plan, the project leader of the capital collaborative innovation key project systemic lupus erythematosus spoke on behalf of the team 30 times at international conferences, published 55 SCI articles as the first/corresponding author, and won the CRA/EAGOR/APLAR/EULAR Young Researcher Award Periodic review of the changes in the treatment of ankylosing spondylitis: from "symptomatic treatment" to "overall management", the new medical insurance catalogue is officially implemented.
What changes will it bring to the diagnosis and treatment of AS? The latest medical insurance drug list is implemented, IL-17A inhibitors will benefit more rigid patients! "Inflammation" must be lost, and anti-inflammatory methods: The relationship between IL-17A and inflammation is explored.
What is the relationship between IL-17A and the pain of ankylosing spondylitis?