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Aktuelle Rheumatologie 2018; 43(02): 161-168
DOI: 10.1055/s-0043-121139
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Neue Therapieansätze bei entzündlichen Gelenkerkrankungen

Novel Therapeutic Strategies in Inflammatory Joint Diseases
Karolina Benesova
1   Sektion Rheumatologie, Innere Medizin V, Universität Heidelberg, Heidelberg
,
Niko Kai Bender
1   Sektion Rheumatologie, Innere Medizin V, Universität Heidelberg, Heidelberg
,
Hanns-Martin Lorenz
1   Sektion Rheumatologie, Innere Medizin V, Universität Heidelberg, Heidelberg
› Author Affiliations
Further Information

Publication History

Publication Date:
27 November 2017 (online)

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Zusammenfassung

Nachdem in mehreren Phase-III-Studien die Wirksamkeit und Sicherheit gezeigt werden konnte, erhielten Anfang dieses Jahres die ersten beiden JAK-Inhibitoren (Baricitinib und Tofacitinib) auch in Deutschland die Zulassung zur Behandlung der mittelschweren bis schweren aktiven rheumatoiden Arthritis. Apremilast, ein selektiver Phosphodiesterase-4 (PDE4)-Inhibitor, wird seit Anfang 2015 als orale Therapie zur Behandlung der Psoriasis und Psoriasis-Arthritis eingesetzt. Bei Psoriasis-Arthritis führt Apremilast u. a. zu einer Verringerung des Schmerzes sowie einer Verbesserung der druckschmerzhaften und geschwollenen Gelenke, der Daktylitis und der Enthesitis. Secukinumab ist ein rekombinanter humaner monoklonaler Antikörper gegen Interleukin (IL)-17 A, der initial zur Behandlung erwachsener Patienten mit mittelschwerer bis schwerer Plaque-Psoriasis eingesetzt wurde. Im November 2015 hat die EMA die Zulassung von Secukinumab auf die Behandlung von Patienten mit aktiver Psoriasis-Arthritis und ankylosierender Spondylitis erweitert. Ustekinumab ist ein humaner monoklonaler Antikorper gegen IL-12/23 und seit 2009 für die Behandlung der Plaque-Psoriasis eingesetzt. Im September 2013 erhielt Ustekinumab durch die EMA auch die Zulassung für die Behandlung der Psoriasisarthritis.

Abstract

After efficacy and safety were demonstrated in several phase III trials, the first 2 JAK inhibitors (baricitinib and tofacitinib) have recently been approved for the treatment of moderate to severe active rheumatoid arthritis in Germany. Apremilast, a selective phosphodiesterase-4 (PDE4) inhibitor, has been used as an oral treatment for psoriasis and psoriatic arthritis since the beginning of 2015. In psoriatic arthritis, apremilast leads to a reduction in pain and an improvement in tender and swollen joints, dactylitis and enthesitis. Secukinumab is a recombinant, fully human, monoclonal antibody neutralising interleukin (IL)-17 A. It was used initially for the treatment of adult patients with moderate to severe plaque psoriasis. In November 2015, the EMA expanded the approval of Secukinumab to active psoriatic arthritis and ankylosing spondylitis. Ustekinumab is a human monoclonal antibody against the p40 subunit of IL-12/23 and has been used for the treatment of plaque psoriasis since 2009. In September 2013, Ustekinumab was also approved by the EMA for the treatment of psoriatic arthritis.

Schlüsselwörter

Baricitinib - Tofacitinib - Apremilast - Secukinumab - Ustekinumab

Key words

baricitinib - tofacitinib - apremilast - secukinumab - ustekinumab
 

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