Use of leflunomide plus TNF-αinhibitors in rheumatoid arthritis

翻译者：刘宁宁 校对者：马丹 审阅者：张莉芸

Abstract Rheumatoid arthritis (RA) is a chronic inflammatory immune-mediated systemic disease which primarily affects the joints. Leflunomide (LFN) is a disease modifying anti-rheumatic drugs (DMARDs) which acts by inhibiting the synthesis of pyrimidines. Several trials have demonstrated the efficacy and safety of LFN alone or in combination with biological agents such as tumor necrosis factor-α(TNF-α) inhibitors in the treatment of RA patients. TNF-αis a pro-inflammatory cytokine known to a have a key role in the pathogenesis of RA. TNF-αinhibitors have demonstrated efficacy as monotherapy or in combination with other anti-inflammatory or DMARDs in the treatment of RA. Five TNF-αinhibitors are available for clinical use and include infliximab, adalimumab, golimumab, certolizumab pegol and etanercept. In this editorial, we briefly discuss the efficacy and safety of LFN and TNF-αinhibitors in the treatment of RA, and the potential beneficial effect of both LFN and TNF-αinhibitors in improving the endothelial dysfunction and in reducing the risk of acute cardiovascular and/or cerebrovascular even

摘要：类风湿关节炎（RA）是一种主要累及关节的免疫介导的慢性炎症性全身性疾病，来氟米特（LFN）是一种抑制嘧啶合成的改善病情抗风湿药（DMARDs）。一些试验已经证实，单独或联合使用生物制剂，如肿瘤坏死因子-α（TNF-α）抑制剂治疗RA患者是有效和安全性的。TNF-α是一种促炎性细胞因子，在RA发病中起关键的作用。TNF-α抑制剂单独治疗RA或联合其他抗炎或改善病情抗风湿药治疗RA的疗效是确切的。临床上有五种TNF-α抑制剂，包括英夫利昔单抗，阿达木单抗，戈利木单抗，妥珠单抗 和依那西普。在这篇论文中，我们简要地讨论LFN和TNF-α抑制剂治疗RA的疗效和安全性，以及LFN和TNF-α抑制剂在改善血管内皮功能和减少急性心血管疾病的风险和/或脑血管事件方面的潜在的有益作用。