With AS to a fight, let the strong straight patient stand up the spine!

The long-term benefit of Chinese patients with as will be enhanced by scFv.ankylosing spondylitis (as) is a chronic inflammatory rheumatic disease with sacroiliac joint and spinal attachment point inflammation as the main symptom. It may involve the eyes, cardiovascular, lung, kidney, nervous system, skin and mucosa, gastrointestinal tract and other extraarticular parts. Severe cases can lead to ankylosing deformity of spine and joint.in the long "marathon" with as, patients will feel pain, stiffness, joint swelling and other discomfort, and easy to fatigue, their physical function and quality of life have been seriously negative impact.with the continuous exploration and elucidation of the pathological mechanism of as, more and more therapeutic targets have been found.IL-17A derived from innate immune cells and adaptive immune cells is a key target for the treatment of as.on April 23, 2020, the State Drug Administration approved the use of scuziumab (IL-17A inhibitor) in the treatment of as.what benefits will this bring to Chinese patients? In clinical application, how to maximize its benefits? We invited Professor Wu Lijun, director of Rheumatology and Immunology Department of Xinjiang Uygur Autonomous Region People's Hospital, and Professor He Dongyi, chief physician of rheumatology department of Shanghai Guanghua integrated traditional Chinese and Western medicine hospital, to share their views on these topics.1 targeting the needs of patients and achieving the treatment goals. The treatment objectives of as mainly include the following four aspects: control of disease symptoms and inflammation degree, prevention of structural damage progress, maintenance of patients' function and social participation, and improvement of health-related quality of life [1,2].IL-17A is a newly discovered pathological factor that plays a key role in the occurrence and development of as. It is located in the downstream of the cytokine network system and is related to the regulation of inflammation and new bone formation [3,4].studies have shown that inhibition of IL-17A can not only control inflammation, but also inhibit the formation of new bone, effectively relieve the clinical symptoms of as, delay imaging progress and reduce the destruction of bone structure [5,6].therefore, targeted inhibition of IL-17A will help to achieve the therapeutic goal of as.in the measure 1 study, nearly 80% of the patients received scuzibizumab i.v. → 150mg s.c., and nearly 80% of the patients had sustained remission of symptoms and signs within 5 years.in the fifth year, 78% of the patients achieved asas20 and 65% of the patients achieved asas40 [7], indicating that scuziumab played a good role in the control of disease symptoms (Fig. 1).Figure 1: the measure1 study showed that the efficacy of scuzibizumab in the treatment of as was long-lasting and the response lasted for up to 5 years. Osteophyte formation is an important disease feature of as patients.in the natural course of disease, patients may experience a series of conditions, such as osteoarthritis, bone destruction, new bone formation, bone fusion, and even disability.scuziumab has excellent performance in inhibiting imaging progress, which can effectively prevent structural and functional damage.measure1 study showed that nearly 80% of patients did not show any radiological damage after 208 weeks of treatment with i.v. → 150mg s.c. (msasss score change from baseline & lt; 2) [8], and structural damage was delayed (Fig. 2). in addition, during the treatment, Bath Ankylosing Spondylitis measurement index (basmi) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores were stable and showed a downward trend, and the patients' activity function continued to improve compared with the baseline [7] (Fig. 3). Figure 2: measure1 study showed that 79% of patients treated with scuzibizumab had no imaging progress within 4 years. Figure 3: measure1 study showed that after 5 years of continuous treatment, the structure and function of patients were maintained well, and the long-term treatment goal of as was to improve the quality of life of patients. measure 1 study showed that the SF-36 PCs score and quality of life of patients were significantly improved after 16 weeks of treatment with scuzibizumab i.v. → 150mg s.c., which lasted for 260 weeks [7,9] (Fig. 4). Figure 4: measure1 study shows that sikuqiyoumab can continuously improve the health of patients. Professor Wu Lijun said that in the clinical studies she participated in before, she found that the effect of scuziumab was rapid, and the clinical symptoms of subjects, such as back pain and morning stiffness, could be significantly relieved within one week, which was significantly different from those in the placebo control group. moreover, the improvement of adhesitis in the subjects treated with scuziumab was more obvious and targeted. the application and promotion of scuziumab in the treatment of as will help to achieve the goal of as treatment more comprehensively. Video 2 of Professor Wu Lijun's interview video 2: rational drug use and standardized treatment can maximize the benefits. While paying attention to the efficacy of drugs, we should also pay attention to the possible adverse reactions, so as to ensure the medication safety of patients is the premise of drug treatment. in today's field of drug therapy, biological agents have been paid more and more attention and clinical application. In the process of using biological agents, we should pay attention to their potential side effects, such as infection risk, tumor risk, abnormal blood system, etc. affected by many factors such as individual differences and mechanism of action, the efficacy and safety of different biological agents are different. China is a big country of tuberculosis and hepatitis B. in as patients, the infection rate of tuberculosis and hepatitis B is about 25% [10,11]. In the treatment process, we must pay attention to the risk of tuberculosis infection and HBV reactivation. previous use of TNF inhibitors in the treatment of as has achieved good results, but there are also some adverse reactions, such as increased susceptibility to tuberculosis, increased risk of HBV reactivation, etc. [12-15]. however, in the existing treatment studies, there is no report of increased susceptibility to tuberculosis or reactivation of HBV caused by the use of scuzibizumab [8], so it has certain advantages in this respect. in the measure series and real-world studies, the use of scuzibizumab did not significantly increase the risk of major adverse cardiovascular events (MACE) and severe infections (figures 5 and 6) [16, 17]. the above clinical data indicate that scuziumab is well tolerated in the treatment of as. Figure 5: the incidence of adverse events in the summary analysis of measure clinical studies when using scuzibizumab. Figure 6: real world research and analysis show that the safety of scuziumab is good. In the interview, Professor He Dongyi specially emphasized that the overall safety of sikuqiyoumab targeting IL-17A is good. In order to give full play to its efficacy, we should be strict Standard and standardized drug use - especially in the case of long course of disease in Chinese patients with as, there may be some other diseases, such as cardiovascular diseases, etc. only rational drug use and standardized treatment can maximize the benefits of drugs and make patients get more benefits. Professor He Dongyi interview video 3 expert message: hope more patients benefit from it. Sikuqiyoumab has been approved as an indication in China. On the one hand, it provides clinicians with new weapons to treat as, on the other hand, it also provides patients with new treatment options. the etiology of as is complex and the pathogenesis is not clear. In addition, the individual differences between patients and patients are large. Diversified targeted biological agents will help to achieve better individualized treatment and improve the prognosis of patients. for the application prospect, both experts expressed that they were looking forward to the promotion and application of scuzibizumab in the field of as in China, which means that there will be more clinical data and clinical experience accumulation. rich clinical data and experience will benefit more patients, thus forming a virtuous circle; at the same time, in order to maximize the benefits, clinicians should strictly grasp the indications, pay attention to the curative effect, and at the same time, do a good job in monitoring adverse reactions and standardize drug use. < br / < br / < br / < br / < br / < br / < br / < br / < br / References: [1] Smolen JS, et al. Ann Rheum dis. 2018; 77:3 – 17. [2] van der Heijde D, et al. Ann Rheum dis. 2017 Jun; 76 (6): 978-991. 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Korbel, et al. Microbes and infection 10 (2008) 995e1004. [14] Mohsen moghoofei, et al. Microbiol pathogenesis 114 (2018) 436-443. [15] Chyuan it, et al. Cell [16] deodhar a et al. Arthritis res ther. 2019; 21 (1): 111. [17] Schreiber s et al. Ann Rheum dis. 2019; 78 (4): 473-479. - end love me!