摘要
银屑病是一种慢性、复发性、免疫介导的皮肤和关节疾病,全球范围内广泛分布,对人的身心健康造成极大损害。目前银屑病的治疗方案主要是控制症状为主,尚无有效治愈银屑病的方法。2022年9月9日,美国食品药品管理局(FDA)批准Deucravacitinib(BMS-986165)用于成人中重度斑块银屑病的治疗;2022年9月26日,日本药品和医疗器械管理局(PMDA)批准Deucravacitinib用于斑块型银屑病、泛发性脓疱型银屑病和红皮病型银屑病的治疗。Deucravacitinib通过与酪氨酸激酶2(TYK2)调控域的特异性结合对TYK2发挥抑制作用,抑制TYK2变构,进而抑制TY2活性;对TYK2具有高选择性和高亲和力,对JAK激酶1-3(JAK1-3)无明显抑制效应,可有效抑制银屑病相关的I型干扰素(IFN)、白细胞介素(IL)-12和IL-23通路。临床研究中Deucravacitinib常见不良反应为上呼吸道感染、血肌酸激酶升高、单纯疱疹、口腔溃疡等。Deucravacitinib 6 mg·d^(-1)QD能显著减少银屑病皮损面积和改善患者生活质量,有效性和安全性良好,药动学特征良好,有望成为治疗银屑病等自身免疫性疾病的治疗药物。
Psoriasis,a chronic,recurrent,immune mediated skin and joint disease,have great significant impact on people's physical and mental health.At present,there is no effective therapeutic options to cure psoriasis.The current treatment strategy is mainly to control its symptoms.On 9 September 2022,FDA approved deucravacitinib(BMS-986165)for the treatment of moderate to severe psoriasis.On 26 September 2022,deucravacitinib was subsequently approved by Japan Pharmaceuticals and Medical Divices Agency(PMDA)for the treatment of plaque psoriasis,generalized pustular psoriasis and erythrodermic psoriasis.Deucravacitinib inhibit the activity of tyrosine kinase-2(TYK2)through specific binding with the regulatory domain of TYK2 pseudokinase,strongly inhibiting isomerization of TYK2 and inhibit immune signaling of IL-12,IL-23,and type I interferons without interfering with other critical systemic functions.Deucravacitinib has high selectivity and affinity for TYK2,and has no obvious inhibitory effect on The Janus kinase 1-3(JAK1-3),effectively inhibiting psoriasis related type I interferon(IFN),interleukin(IL)-12 and IL-23 pathways.Common adverse action of deucravacitinib in clinical studies were upper respiratory tract infection,elevated creatine kinase,herpes simplex,and oral ulcers.Deucravacitinib QD 6 mg·d^(-1)significantly reduce psoriasis skin lesions and improve patients′quality of life.Deucravacitinib has good efficacy,safety and good pharmacokinetic characteristics,and it is expected to become a therapeutic drug for autoimmune diseases such as psoriasis.
作者
邢俊香
侯立强
孙燕
陈萍
XING Junxiang;HOU Liqiang;SUN Yan;CHEN Ping(Zibo Central Hospital,Shandong Province,Shandong Zibo 255000,China)
出处
《中国医药导刊》
2023年第12期1230-1235,共6页
Chinese Journal of Medicinal Guide
