DOI: https://doi.org/10.22141/2307-1257.8.3.2019.176456

Immunobiological drugs in the treatment of rheumatic diseases

O.O. Melnyk

Abstract


Rheumatic diseases (RD) are among the most common chronic diseases of the musculoskeletal system and connective tissue which are found in both adults and children. The cause of these pathological conditions can be changes in the functioning of the immune system, inflammation, infections and other factors. In some cases, they lead to disability and have a significant impact on the quality of life and lifetime. There are non-pharmacological and pharmacological treatments for RD. The first line (non-pharmacological) treatment of most RDs consists in changing the lifestyle (exercises, correct diet, smoking cessation). Standard pharmacological treatment includes non-steroidal anti-inflammatory drugs, glucocorticoids, anti-inflammatory drugs that suppress acute phase response, help reduce the level of autoantibodies. Unfortunately, although non-steroidal anti-inflammatory drugs help control RD symptoms reducing pain, swelling and inflammation, they do not slow down the disease progression. This also refers to glucocorticoids which are anti-inflammatory hormones associated with cortisol, a steroid produced naturally in the body. Despite their advantages, glucocorticoids have significant side effects including diabetes, osteoporosis, hypertension, cataract and susceptibility to infections. In recent years, new data on the pathogenesis of rheumatic diseases has been obtained that has contributed to the possibility of creating innovative immunobiological drugs. The development of such drugs has revolutionized the therapeutic approach to chronic rheumatic diseases, especially in patients who are resistant to standard treatment. The mechanism of action of these immunobiological drugs is based on the inhibition of specific or molecular targets directly involved in the disease pathogenesis. They include tumor necrosis factor blockers, interleukin-1, -6, 17A receptor antagonists, CD20, CD80/CD86 blockers and T-cell costimulation blocker. Their use allows us to improve the prognosis and achieve clinical remission in a significant number of patients.

Keywords


rheumatic diseases; immunobiological drugs; tumor necrosis factor blockers; interleukin-1, -6, 17A receptor antagonists; CD20, CD80/CD86 blockers; T-cell соstimulation blocker; review

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