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Biologika in der Rheumatologie

Biologics in rheumatology

  • Schwerpunkt: Monoklonale Antikörper
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Monoklonale Antikörper und Fusionsproteine wurden vor 20 Jahren in die klinische Rheumatologie eingeführt. Heute sind sie ein fester Bestandteil der modernen internistischen Praxis.

Fragestellung

Überblick über die Breite der derzeit im klinischen Einsatz befindlichen Biologika.

Material und Methoden

Auswertung publizierter Zulassungsstudien und Leitlinienempfehlungen, Diskussion immunologischer Grundlagen und Ziele in der Therapie mit Biologika.

Ergebnisse

Monoklonale Antikörper und Fusionsproteine zur Beeinflussung von Zytokinsignalen, der T‑Zell-Kostimulation und B‑Zell-Funktion sind die wichtigsten therapeutischen Neuerungen in der Therapie rheumatologischer Erkrankungen. Sie sind heute aus der Behandlung der mittelschweren und schweren Verlaufsformen von rheumatoider Arthritis, Spondylarthropathien sowie Vaskulitiden nicht mehr wegzudenken.

Schlussfolgerung

Obwohl eine Heilung oder dauerhafte Symptomfreiheit bei rheumatologischen Autoimmunerkrankungen noch immer nicht möglich ist, sind durch den frühen Einsatz von Biologika heute sehr viel günstigere Erkrankungsverläufe mit geringen Langzeiteinschränkungen erreichbar.

Abstract

Background

Monoclonal antibodies and fusion proteins were introduced into clinical rheumatology 20 years ago. Nowadays they are an established component of modern internal medical practice.

Objective

This article gives an overview of the breadth of biologics currently in clinical use.

Material and methods

Evaluation of published approval studies and guideline recommendations, discussion of the immunological principles and targets in the treatment with biologics.

Results

Monoclonal antibodies and fusion proteins for influencing cytokine signals, T‑cell costimulation and B‑cell function are the most important innovations in the treatment of rheumatological diseases. Nowadays they are indispensible for the treatment of moderate and severe disease courses of rheumatoid arthritis, spondylarthropathies and vasculitides.

Conclusion

Although a cure or permanent freedom from symptoms in rheumatological autoimmune diseases is still not possible, much more favorable disease courses with less long-term limitations can be achieved by the early administration of biologics.

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Authors and Affiliations

  1. Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie, Hepatologie, Infektionsmedizin, Rheumatologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland

    U. Wagner

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Correspondence to U. Wagner.

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Interessenkonflikt

U. Wagner gibt folgende mögliche Interessenkonflikte an: finanzielle Unterstützung von Forschungsprojekten durch die Firmen Roche, Novartis, BMS, Pfizer. Vortragshonorare von Pfizer, Roche. Teilnahme an klinischen Prüfungen der Sponsoren Roche/Chugai, Novartis, Pfizer, Eli Lilly, BMS, UCB, Abbott.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

J. Mössner, Leipzig

A. Neubauer, Marburg

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Wagner, U. Biologika in der Rheumatologie. Internist 60, 1036–1042 (2019). https://doi.org/10.1007/s00108-019-00676-0

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  • DOI: https://doi.org/10.1007/s00108-019-00676-0

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