Zeitschrift für Rheumatologie

, Volume 69, Issue 7, pp 626–632 | Cite as

Neue Biologika und oral verfügbare neue Medikamente

Was ist noch in der Pipeline?
  • M. Grünke
  • H. Bastian
  • H. Schulze-Koops
  • G.-R. Burmester
Leitthema
First Online:

Zusammenfassung

Biologika haben die Therapie von entzündlich-rheumatischen Erkrankungen in den letzten 10 Jahren revolutioniert. Durch die gezielte Inhibition von inflammatorischen Zytokinen sowie der Blockade von zentralen Zellen, die an einer Entzündungsreaktion beteiligt sind, konnte ein Ausmaß der Entzündungshemmung erreicht werden, das vor der Einführung der Biologika undenkbar war. Die Notwendigkeit, die heutigen Biologika weiter zu entwickeln, basiert vor allem darauf, dass 1. der klinische Effekt zwar bei jedem zugelassenen Biologikum bei der großen Mehrzahl, aber durchaus nicht bei allen Patienten eintritt, dass 2. durch die Blockade wichtiger Mediatoren des Immunsystems Risiken für die Entstehung von Infektionen oder bösartigen Neubildungen bestehen und dass 3. die heutigen Biologika allesamt parenteral verabreicht werden müssen. In der vorliegenden Übersicht portraitieren wir eine Reihe von innovativen Biologika und niedermolekularen Molekülen, die im Moment in klinischen Studien bei Patienten mit entzündlich-rheumatischen Erkrankungen untersucht werden und von denen einige in nächster Zeit das Armamentarium der verfügbaren Biologika in der Rheumatologie erweitern werden.

Schüsselwörter

Rheumatoide Arthritis Biologika T-Zellen B-Zellen Interleukin 17 

New biologics and orally available compounds

What is still in the pipeline?

Abstract

Biologics have revolutionized the treatment of inflammatory joint disease in the last decade. By precisely targeting and inhibiting inflammatory cytokines as well as the blockade of cells centrally integrated in the immune system, inhibition of inflammation has become possible which had been unthinkable before. The medical need to improve our current approach with biologics even more is based on three observations: (1) even though the clinical effect of a given biologic is evident in the majority of patients, not all show a satisfactory response, (2) the blockade of important mediators of the immune system bears the risk of infection and potentially malignant events and (3) all current biologics need to be administered parenterally. The present review describes several innovative biologics and low molecular weight compounds which are currently being investigated in clinical trials in patients suffering from inflammatory rheumatic conditions. Some of them may become a part of our growing armamentarium to treat these diseases which still represent a major burden to the patients and society.

Keywords

Rheumatoid arthritis Biologics T-cells B-cells Interleukin 17 
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Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Novartis, Roche, Pfizer, Wyeth.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • M. Grünke
    • 1
  • H. Bastian
    • 2
  • H. Schulze-Koops
    • 1
  • G.-R. Burmester
    • 2
  1. 1.Rheumaeinheit, Medizinische PoliklinikLudwig-Maximilians-Universität MünchenMünchenDeutschland
  2. 2.Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische ImmunologieCharité-Universitätsmedizin BerlinBerlinDeutschland

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