璩肩墿淇濋殰
鏀粯鏂瑰紡
閰嶉€佹湇鍕�(w霉)
鍞悗鏈嶅嫏(w霉)
闂�(gu膩n)浜庢垜鍊�
瀹夊仴瀵э紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夋椿鎬ф垚鍒嗭細闃块仈(d谩)鏈ㄥ柈鎶�40mg銆傚垎瀛愰噺锛氱磩148KD銆傝紨鏂欙細鏋告珵閰搁垑銆佹灨娅為吀銆佺７閰镐簩姘垑銆佺７閰告矮浜岄垑銆佽敆绯�銆佽仛灞辨ⅷ閰�80銆佹矮姘у寲閳�銆傚湪娌荤檪鐨勯亷绋嬩腑锛屾偅鑰呰淇濇寔鐞嗘€э紝鏍规摎(j霉)鑷韩鐥呮儏鍜岄啱(y墨)鐢熺殑寤鸿锛岄伕鎿囬仼鍚堣嚜宸辩殑娌荤檪鏂规銆傚悓鏅傚爡鎸佸仛濂芥不鐧傞亷绋嬩腑鐨勫悇闋呭伐浣�锛屽鎸夋檪鏈嶈棩銆佸畾鏈熷京(f霉)瑷恒€佺⿳妤甸厤鍚堝悍寰�(f霉)瑷�(x霉n)绶寸瓑锛岀洝閲忔棭鏈熷皣鐥呮儏绌�(w臎n)瀹氫笅渚嗐€� 瑭虫儏
瀹夊仴瀵э紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夌敤娉曠敤閲忥細鎳�(y墨ng)鍦ㄥぇ鑵垮墠閮ㄦ垨涓嬭吂閮ㄦ敞灏勩€傚湪姣忔娉ㄥ皠鏅傞伕鎿囦笉鍚岀殑閮ㄤ綅锛屼笉瑕佸湪鐤肩棝銆佹筏闈�銆佺櫦(f膩)绱�銆佺櫦(f膩)纭€佹湁鐦㈢棔鎴栧濞犵磱鐨勭毊鑶氬崁(q奴)鍩熸敞灏�銆傞€氶亷瑾槑鏇稿彲浠ヤ簡瑙ｅ埌锛屾瘡涓€娆℃敞灏勬偅鑰呮噳(y墨ng)鐣欐剰涓嶈鍦ㄥ悓涓€鍊嬩綅缃紝浠ュ厤鍑虹従(xi脿n)鐨啔鎰熸煋绛変笉鑹従(xi脿n)鐙€銆傚钩鏅備篃鎳�(y墨ng)澶氫簡瑙ｅ熀绀�(ch菙)鐨勬不鐧傚収(n猫i)瀹�锛岀⿳妤垫帉鎻″拰鐞嗚В鐤剧梾涓嶅悓鐨勮檿鐞嗘柟寮�锛屽毚(y谩n)鏍兼寜鐓ч啱(y墨)鐢熺殑瑕佹眰姝ｇ⒑鍘昏檿鐞嗗晱椤屻€� 瑭虫儏
瀹夊仴瀵э紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夋渶甯稿牨鍛婄殑涓嶈壇鍙嶆噳(y墨ng)鏄劅鏌擄紙姣斿榧诲捊鐐�銆佷笂鍛煎惛閬撴劅鏌撳拰榧荤珖鐐庯級銆佹敞灏勯儴浣嶅弽鎳�(y墨ng)锛堢磪鏂�銆佺槞鐧�銆佸嚭琛€銆佺柤鐥涙垨鑵劰锛�銆侀牠鐥涘拰楠ㄩ鑲岃倝鐤肩棝銆傚湪鐢ㄨ棩鏈熼枔鎮ｈ€呭洜瑾�(r猫n)鐪熻瀵熻嚜韬殑鍙嶆噳(y墨ng)锛屼竴鏃﹀嚭鐝�(xi脿n)涓嶈壇鐝�(xi脿n)璞�锛岃鑰愬績鍘婚厤鍚堥啱(y墨)鐢熷仛濂芥噳(y墨ng)灏嶆帾鏂�锛屾牴鎿�(j霉)涓嶅悓鐨勬儏娉佹渻鏈変笉鍚岀殑铏曠悊鏂瑰紡锛岃绲�(ji茅)鍚堥啱(y墨)鍥戝毚(y谩n)鏍间締铏曠悊锛屼笉瑕佹搮鑷笡閲忓拰鍋滆棩鐨勮鐐�锛屼互鍏嶅皪鐥呮儏搴峰京(f霉)涓嶅埄銆� 瑭虫儏
瀹夊仴瀵э紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夌蹇岋細灏嶄簬鏈棩鍝佹垨鍒跺姂涓叾瀹冩垚鍒嗛亷鏁忚€�?锛涢鏈夎秺Y(ji茅)鏍告垨鑰呭叾瀹冨毚(y谩n)閲嶇殑鎰熸煋鐤炬偅锛岃濡傛晽琛€鐧ュ拰姗�(j墨)鏈冩劅鏌撶瓑锛堝弮瑕媅娉ㄦ剰浜嬮爡]閮ㄥ垎锛夈€傚湪鐢ㄨ棩鏈熼枔锛屾偅鑰呮噳(y墨ng)鍤�(y谩n)鏍奸伒寰啱(y墨)鐢熺殑寤鸿锛屾寜鏅傛寜閲忔湇钘ワ紝涓嶈闅ㄦ剰鏇存敼鐢ㄨ棩鏂规銆傚悓鏅�锛屽畾鏈熷京(f霉)鏌ヨ韩楂旂媭娉佷篃鏄繀涓嶅彲灏戠殑锛岄€欐湁鍔╀簬鍙婃檪浜嗚В鐥呮儏鐨勮畩鍖栧拰瑾�(di脿o)鏁存不鐧傛柟妗�?锛涢鍝屸偓鎳�(y墨ng)娉ㄦ剰瑙€瀵熷彲鑳藉嚭鐝�(xi脿n)鐨勪笉鑹弽鎳�(y墨ng)锛屽鏈夌暟甯告噳(y墨ng)鍙婃檪鍚戦啱(y墨)鐢熷牨鍛�銆� 瑭虫儏
瀛曞│浣滅偤涓€椤炵壒娈婄殑缇ら珨锛屽湪鐢ㄨ棩涓婂繀闋堣璎�(j菒n)鎱�锛屾牴鎿�(j霉)瑾槑鏇稿収(n猫i)瀹瑰彲浠ョ煡閬撳瓡濠﹀強灏氭湭閲囧彇鍙潬閬垮瓡鎺柦鐨勮偛榻″│濂冲強鍝轰钩鏈熷│濂崇鐢ㄤ締姘熺背鐗圭墖銆傚叾娆�锛屾偅鑰呮噳(y墨ng)鐣�(d膩ng)鍦ㄦ瑕�(gu墨)鐨勯啱(y墨)闄㈡垨钘ュ簵瑭㈠晱渚嗘盁绫崇壒鐗囧児鏍�锛屾瘮濡傚湪鐩婅棩搴峰痉妯傚ぇ钘ユ埧灏辫兘浜嗚В鍒板叿楂斾俊鎭€� 瑭虫儏
涓€鑸亷鏈熺殑钘ョ墿閮戒笉閬╃敤浜庣柧鐥呯殑娌荤檪锛屾墍浠ユ偅鑰呮湅鍙嬫噳(y墨ng)瑭茶娉ㄦ剰瑙€瀵�锛屼篃鎳�(y墨ng)瑭茶娉ㄦ剰鍒版瑕�(gu墨)鐨勫钩鑷哄幓瑭㈠晱鍍规牸鐩搁棞(gu膩n)鐨勪俊鎭�銆傜幓鐠冮吀閳夋敞灏勬恫淇濊唱(zh矛)鏈熸槸42鍊嬫湀锛屾不鐧傝畩褰㈡€ц啙闂�(gu膩n)绡€(ji茅)鐥呫€佽偐闂�(gu膩n)绡€(ji茅)鍛ㄥ湇鐐�銆� 瑭虫儏
鐩婅辰鏅湪閱�(y墨)闄互鍙婅棩搴楃殑鍍规牸骞朵笉鐩稿悓锛屽湪閱�(y墨)闄㈡垨鑰呰棩鎴挎噳(y墨ng)瑭查兘鏈夐姺鍞€傜泭璩芥櫘鐢ㄤ簬娌荤檪锛� 涓害鍙婇噸搴︽椿鍕曟€ч棰�(f膿ng)婵曢棞(gu膩n)绡€(ji茅)鐐�锛� 18姝插強18姝蹭互涓婃垚浜轰腑搴﹀強閲嶅害鏂戝鐙€閵€灞戠梾锛� 娲诲嫊鎬у挤(qi谩ng)鐩存€ц剨鏌辩値銆� 瑭虫儏
娉板崥缍紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夌蹇岋細灏嶄簬闃块仈(d谩)鏈ㄥ柈鎶楁垨鍒跺姂涓叾瀹冩垚浠介亷鏁忚€咃紙鍙冭[鎴愪唤]閮ㄥ垎锛�?锛涢鏈夎秺Y(ji茅)鏍告垨鑰呭叾瀹冨毚(y谩n)閲嶇殑鎰熸煋鐤炬偅锛岃濡傛晽琛€鐧ュ拰姗�(j墨)鏈冩劅鏌撶瓑銆傛偅鑰呭钩鏅傝鍋氬ソ韬珨鐨勪繚鏆栨帾鏂�锛岄伩鍏嶈韩楂斿彈瀵掑彈娑�锛屼笉瑕侀暦鏅傞枔鍦ㄩ櫚鍐锋疆婵曠殑鐠�(hu谩n)澧冧笅灞呬綇銆� 瑭虫儏
娉板崥缍紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夌敤娉曠敤閲忔噳(y墨ng)鍦ㄥぇ鑵垮墠閮ㄦ垨涓嬭吂閮ㄦ敞灏�銆傚湪姣忔娉ㄥ皠鏅傞伕鎿囦笉鍚岀殑閮ㄤ綅锛屼笉瑕佸湪鐤肩棝銆佹筏闈�銆佺櫦(f膩)绱�銆佺櫦(f膩)纭�銆佹湁鐦㈢棔鎴栧濞犵磱鐨勭毊鑶氬崁(q奴)鍩熸敞灏�?锛涢鍜€垛拋搴鹃緤甯斤讥顕╄儳顮€顑岃媻棣嶇湤w鍙楀瘨鍙楁都锛屽彲浠ラ仼鐣�(d膩ng)鍋氫竴浜涘悍寰�(f霉)閸涚厜銆� 瑭虫儏
娉板崥缍紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夐仼鎳�(y墨ng)鐧ワ細椤為ⅷ(f膿ng)婵曢棞(gu膩n)绡€(ji茅)鐐�銆傛湰鍝佽垏鐢叉皑铦跺懁鍚堢敤锛岀敤浜庢不鐧傦細灏嶆敼鍠勭梾鎯呮姉棰�(f膿ng)婵曡棩锛圖MARDs)锛屽寘鎷敳姘ㄨ澏鍛ょ檪鏁堜笉浣崇殑鎴愬勾涓噸搴︽椿鍕曟€ч棰�(f膿ng)婵曢棞(gu膩n)绡€(ji茅)鐐庢偅鑰�銆傛偅鑰呭钩鏅傝娉ㄦ剰鍋氬ソ淇濇殩鎺柦锛岄伩鍏嶈韩楂斿彈瀵掑彈娑�銆� 瑭虫儏
鏂芥矝鐗癸紙鐜荤拑閰搁垑娉ㄥ皠娑诧級涓嶈壇鍙嶆噳(y墨ng)锛氬€嬪垾鎮ｈ€呮敞灏勯儴浣嶅彲鍑虹従(xi脿n)鐤肩棝銆佺毊鐤�銆佺槞鐧㈢瓑鐧ョ媭锛屼竴鑸�2-3澶╁収(n猫i)鍙嚜琛屾秷澶憋紝鑻ョ櫏鐙€鎸佺簩(x霉)涓嶉€€锛屾噳(y墨ng)鍋滄鐢ㄨ棩锛岄€�(j矛n)琛屽繀瑕佺殑铏曠悊?锛涢鍜傜秿r鍙互浣跨敤鐔辨瘺宸炬斁鍦ㄨ偐鑶€閮ㄤ綅锛岃兘澶犱績閫�(j矛n)琛€娑插惊鐠�(hu谩n)锛屾笡杓曡偐閮ㄧ値鐧ュ拰鑲岃倝绶婂嫉鐨勭従(xi脿n)璞�銆� 瑭虫儏
椤為ⅷ(f膿ng)婵曟€ч棞(gu膩n)绡€(ji茅)鐐庨渶瑕佺⿳妤电敤钘ユ不鐧�锛岃€屾礇绱㈡礇鑺垑鐗囪鏄庢浉鐨勭敤娉曠敤閲忥細椋悗鍙ｆ湇锛涙參鎬х値鐧ョ柤鐥涳細鎴愪汉姣忔60mg锛�1鐗囷級锛屾瘡鏃ヤ笁娆�锛涙€ユ€х値鐧ョ柤鐥涳細闋撴湇60锝�120mg锛�1锝�2鐗囷級锛涘彲鏍规摎(j霉)骞撮健銆佺櫏鐙€閬╃暥(d膩ng)澧炴笡锛屼竴鏃ユ渶澶у姂閲忎笉瓒呴亷180mg锛�3鐗囷級銆傜敤钘ユ湡闁�锛屾偅鑰呰閬垮厤椋查厭銆� 瑭虫儏
姣忓€嬭棩鍝佺殑鐢ㄦ硶鐢ㄩ噺閮芥湁涓嶅悓鐨勮(gu墨)瀹�锛岃€屾偅鑰呬篃鎳�(y墨ng)瑭茶娉ㄦ剰浜嗚В娌荤檪绱�(x矛)绡€(ji茅)锛屾牴鎿�(j霉)瑾槑鏇哥殑淇℃伅鍙互鐭ラ亾瑗挎▊钁嗙珐瑙ｉ棰�(f膿ng)婵曢棞(gu膩n)绡€(ji茅)鐐庣殑鐧ョ媭鍜岄珨寰佹帹钖﹀姂閲忕偤100mg 鑷�200mg锛屾瘡鏃ュ叐娆�銆� 瑭虫儏
钘ョ墿鎴愪唤涔熼渶浜嗚В锛岀泭璩芥櫘娉ㄥ皠鐢ㄩ噸绲勪汉II鍨嬭叓鐦ゅ姝诲洜瀛愬彈楂�-鎶楅珨铻嶅悎铔嬬櫧涓昏鎴愪唤锛氭瘡鐡跺惈閲嶇祫浜衡叀鍨嬭叓鐦ゅ姝诲洜瀛愬彈楂攡鎶楅珨铻嶅悎铔嬬櫧锛坮hTNFR:Fc锛�12.5姣厠鎴�25姣厠銆傚皪浜庨妧灞戠梾鎮ｈ€呬締瑾�锛岃壇濂界殑鐢熸椿缈�(x铆)鎱ｄ篃鏄潪甯搁棞(gu膩n)閸电殑銆傜爺绌惰瓑瀵�锛屽鍔�銆佷紤鎭笉瓒冲拰涓嶈(gu墨)寰嬬殑浣滄伅閮芥渻鍔犻噸閵€灞戠梾鐨勭櫏鐙€銆傚洜姝�锛屾偅鑰呮噳(y墨ng)閲嶈蹇冪悊鍋ュ悍锛屼繚鎸佺⿳妤垫▊瑙€鐨勫績鎱�(t脿i)锛岄仼鐣�(d膩ng)鍙冨姞浼戦枒娲诲嫊鑸囬亱鍕�锛屽鐟滀冀銆佸啣鎯崇瓑锛屽公鍔╃珐瑙ｆ儏绶掑拰澹撳姏銆� 瑭虫儏
鐛ㄤ竴鍛宠啝鍥婄蹇岋細1銆佸瓡濠︾鐢�銆�2銆佸皪鏈搧閬庢晱鎴栨湁鍤�(y谩n)閲嶄笉鑹弽鎳�(y墨ng)鐥呭彶鑰呯鐢ㄣ€傛墍浠ユ牴鎿�(j霉)韬珨鐨勬儏娉侀€�(j矛n)琛岃棩鐗╃殑鎿嶄綔寰堥噸瑕�锛屽湪鏃ュ父鐢熸椿涓ぇ瀹朵篃瑕佹敞鎰忚鍋氬ソ閫欑ó鐤剧梾鐨勯爯(y霉)闃�锛屾瘮濡傚ぇ瀹惰鐩￠噺澶氫紤鎭紝閬垮厤鍋氬妵鐑堢殑閬嬪嫊锛屼絾瑕佸悆鐕熼(y菐ng)璞愬瘜鐨勯鐗╀締瑾�(di脿o)鐞嗚韩楂斻€� 瑭虫儏
鑹炬▊鏄庯紙宸寸憺鏇垮凹鐗囷級鎺ㄨ枽鍔戦噺鐐�2mg姣忔棩涓€娆�銆傚皪浜庝笅杩颁汉缇わ紝鍙€冩叜4mg姣忔棩涓€娆＄郸钘�?锛涢鍛栨ⅱ閰濄劅^鐗╃悊娌荤檪鐨勬柟娉曚締鑸掔珐韬珨鐨勪笉閬╃櫏鐙€锛屾瘮濡傚眬閮ㄧ啽鏁�銆佹寜鎽╃瓑锛岃兘澶犱績閫�(j矛n)琛€娑插惊鐠�(hu谩n)銆� 瑭虫儏
淇編妯傦紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夐仼鎳�(y墨ng)鐧ワ細椤為ⅷ(f膿ng)婵曢棞(gu膩n)绡€(ji茅)鐐庢湰鍝佽垏鐢叉皑铦跺懁鍚堢敤锛岀敤浜庢不鐧傦細灏嶆敼璁婄梾鎯呮姉棰�(f膿ng)婵曡棩锛圖MARDs锛�锛屽寘鎷敳姘ㄨ澏鍛ょ檪鏁堜笉浣崇殑鎴愬勾涓噸搴︽椿鍕曟€ч棰�(f膿ng)婵曢棞(gu膩n)绡€(ji茅)鐐庢偅鑰�銆傚缓璀版偅鑰呮棩甯歌鍔犲挤(qi谩ng)鍋氬ソ璀�(h霉)鐞嗘帾鏂斤紝鍙互澶氶€�(j矛n)琛屾棩甯稿姛鑳介崨鐓�锛屽寮�(qi谩ng)韬珨鐨勯珨璩�(zh矛)銆� 瑭虫儏
鐩婅辰鏅紙娉ㄥ皠鐢ㄩ噸绲勪汉鈪″瀷鑵槫澹炴鍥犲瓙鍙楅珨-鎶楅珨铻嶅悎铔嬬櫧锛変富瑕佺祫鎴愭垚鍒嗘瘡鏀惈閲嶇祫浜衡叀鍨嬭叓鐦ゅ姝诲洜瀛愬彈楂�-鎶楅珨铻嶅悎铔嬬櫧锛坮hTNFR锛欶c锛�12.5姣厠鎴�25姣厠锛岀敇闇查唶40姣厠锛岃敆绯�10姣厠銆傛偅鑰呭湪鎮ｇ梾鏈熼枔瑕佷繚鎸佽壇濂界殑鐢熸椿缈�(x铆)鎱�锛屼繚璀夎嚜宸辩潯鐪犲厖瓒�銆� 瑭虫儏
瑗挎▊钁嗭紙濉炰締鏄斿竷鑶犲泭锛夊叿楂旂殑鍍规牸闇€瑕佹牴鎿�(j霉)钘ョ墿椤炲瀷姹哄畾銆傜敤钘ユ湡闁撴噳(y墨ng)鍤�(y谩n)鏍奸伒閱�(y墨)鍥戯紝閬垮厤绉佽嚜澧炴笡钘ョ墿鍔戦噺銆傚湪鎮ｇ梾鏈熼枔鎮ｈ€呬笉瑕侀亷浜庣劍鎱�锛岃瑾�(di脿o)鏁村ソ鑷繁鐨勫績鎱�(t脿i)锛屼繚鎸佸績鎯呯殑鎰夋倕銆傛棩甯歌椁�(y菐ng)鎴愬ソ鐨勪綔鎭(gu墨)寰�锛岄伩鍏嶉亷搴﹀嫗绱�锛岀洝閲忛伩鍏嶅共閲嶉珨鍔涙椿銆� 瑭虫儏
娉板崥缍紙闃块仈(d谩)鏈ㄥ柈鎶楁敞灏勬恫锛夊叿楂旂殑鍍规牸闇€瑕佹牴鎿�(j霉)钘ョ墿椤炲瀷姹哄畾锛岀敤钘ユ湡闁撴噳(y墨ng)鍤�(y谩n)鏍奸伒閱�(y墨)鍥�銆傜恫(w菐ng)涓婅卜钘ユ偅鑰呭彲浠ヤ締鐩婅棩搴峰痉妯傚ぇ钘ユ埧璩艰卜銆傛偅鑰呭钩鏅傝娉ㄦ剰鍋氬ソ淇濇殩鎺柦锛屾笡杓曞眬閮ㄧ柤鐥涘拰鑵劰鐨勭従(xi脿n)璞★紝鍥犵偤瀵掑喎鏈冨皫(d菐o)鑷磋绠℃敹绺�锛屽奖闊垮埌闂�(gu膩n)绡€(ji茅)閮ㄤ綅鐨勮娑插惊鐠�(hu谩n)銆� 瑭虫儏
姝ｅ搧淇濋殰 鏀惧績閬歌臣
鐢ㄨ棩鍏ㄧ▼鎸囧皫(d菐o)
寤犲鎺堟瑠(qu谩n) 姝ｅ搧娓犻亾
瀹夊叏鏀惧績 闅辩閰嶉€�
