{"id":783,"date":"2020-02-22T11:34:31","date_gmt":"2020-02-22T03:34:31","guid":{"rendered":"http:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=783"},"modified":"2020-09-22T15:57:24","modified_gmt":"2020-09-22T07:57:24","slug":"%e7%94%9f%e7%89%a9%e8%a3%bd%e5%8a%91%e6%b2%bb%e7%99%82%e9%81%8e%e6%95%8f%e5%85%8d%e7%96%ab%e9%a2%a8%e6%bf%95%e7%96%be%e7%97%85%e4%b9%8b%e4%b8%96%e7%95%8c%e8%b6%a8%e5%8b%a2","status":"publish","type":"post","link":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=783","title":{"rendered":"\u751f\u7269\u88fd\u5291\u6cbb\u7642\u904e\u654f\u514d\u75ab\u98a8\u6fd5\u75be\u75c5\u4e4b\u4e16\u754c\u8da8\u52e2"},"content":{"rendered":"\n

\u6587\/\u904e\u654f\u514d\u75ab\u98a8\u6fd5\u79d1 \u9b4f\u6b63\u5b97<\/strong> \u4e3b\u4efb<\/p>\n\n\n\n

\u5728\u9580\u8a3a\u5e38\u6709\u60a3\u8005\u554f\u6211\uff1a\u300c\u514d\u75ab\u75be\u75c5\u4e5f\u53ef\u4ee5\u548c\u764c\u75c7\u4e00\u6a23\u4f7f\u7528\u6a19\u9776\u85e5\uff1f\u300d\u662f\u7684\uff0c\u4e8b\u5be6\u4e0a\u4e0d\u662f\u764c\u75c7\u624d\u53ef\u4f7f\u7528\u6a19\u9776\u85e5\uff0c\u5728\u904e\u654f\u514d\u75ab\u98a8\u6fd5\u79d1\u4e5f\u5e38\u4f7f\u7528\u6a19\u9776\u85e5\uff0c\u4f46\u672c\u79d1\u901a\u7a31\u70ba\u751f\u7269\u88fd\u5291\u3002<\/p>\n\n\n\n

\u300c\u4f55\u7a2e\u75c5\u60c5\u9700\u8981\u4f7f\u7528\u751f\u7269\u88fd\u5291\u5462\uff1f\u300d\u904e\u53bb\u4ee5\u4f86\uff0c\u81ea\u9ad4\u514d\u75ab\u75be\u75c5\u4e3b\u8981\u7684\u6cbb\u7642\u85e5\u7269\u70ba\u985e\u56fa\u9187\u3001\u6d88\u708e\u6b62\u75db\u85e5\u3001\u514d\u75ab\u8abf\u7bc0\u5291\uff08\u75be\u75c5\u4fee\u98fe\u6297\u98a8\u6fd5\u85e5\u7269\uff09\u53ca\u514d\u75ab\u6291\u5236\u5291\u7b49\u3002\u8fd1\u5e74\u96a8\u8457\u514d\u75ab\u5b78\u3001\u5206\u5b50\u751f\u7269\u5b78\u53ca\u57fa\u56e0\u5de5\u7a0b\u7684\u9032\u6b65\uff0c\u91dd\u5c0d\u81ea\u9ad4\u514d\u75ab\u75be\u75c5\u7279\u6709\u7684\u514d\u75ab\u5206\u5b50\uff0c\u79d1\u5b78\u5bb6\u7814\u767c\u51fa\u7684\u5404\u7a2e\u751f\u7269\u88fd\u5291\u3002\u9019\u4e9b\u65b0\u85e5\u7336\u5982\u5b9a\u5411\u5c0e\u5f48\u822c\u7cbe\u78ba\u5730\u63cf\u6e96\u7570\u5e38\u7684\u514d\u75ab\u5206\u5b50\uff0c\u800c\u4e0d\u6703\u50b7\u5bb3\u6b63\u5e38\u7d30\u80de\uff0c\u5c31\u662f\u514d\u75ab\u6a19\u9776\u7642\u6cd5(\u751f\u7269\u88fd\u5291)\u3002<\/p>\n\n\n\n

\u514d\u75ab\u6a19\u9776\u7642\u6cd5\u662f\u9069\u7576\u7684\u963b\u65b7\u514d\u75ab\u5206\u5b50\u4f86\u9054\u5230\u6cbb\u7642\u6548\u679c\u7684\u85e5\u7269\uff0c\u963b\u65b7\u76ee\u6a19\u662f\u8840\u6db2\u4e2d\u7684\u7d30\u80de\u56e0\u5b50\u3001\u53d7\u9ad4\u3001\u6216\u7d30\u80de\u5167\u7684\u4fe1\u865f\u50b3\u905e\u901a\u9053\u3002<\/p>\n\n\n\n

\u514d\u75ab\u6a19\u9776\u7642\u6cd5\u5206\u70ba\u4ee5\u4e0b\u5169\u985e<\/strong><\/p>\n\n\n\n
\n \u985e\u5225<\/strong>\n <\/td>\n \u5206\u5b50\u5927\u5c0f<\/strong>\n <\/td>\n \u7d66\u85e5\u65b9\u5f0f<\/strong>\n <\/td>\n \u4f5c\u7528\u4f4d\u7f6e<\/strong>\n <\/td><\/tr>
\n \u751f\u7269\u88fd\u5291\n <\/td>\n \u5927\u5206\u5b50(\u86cb\u767d)\uff0c\u9700\u7528\u52d5\u7269\u5982\u8001\u9f20\u53ca\u57fa\u56e0\u5de5\u7a0b\u88fd\u9020\u3002\n <\/td>\n \u6ce8\u5c04\u7ed9\u85e5\n <\/td>\n \u7ec6\u80de\u56e0\u5b50\u3001\u53d7\u9ad4\n <\/td><\/tr>
\n \u5c0f\u5206\u5b50\u85e5\u7269\n <\/td>\n \u5c0f\u5206\u5b50\n \u5316\u5b78\u5408\u6210\n <\/td>\n \u53e3\u670d\u7ed9\u85e5\n <\/td>\n \u7d30\u80de\u5167\u8a0a\u606f\u50b3\u905e\u8def\u5f91\n <\/td><\/tr><\/tbody><\/table>\n\n\n\n

\u5168\u7403\u73fe\u6709\u514d\u75ab\u75be\u75c5\u6a19\u9776\u85e5\u7269<\/strong><\/p>\n\n\n\n

\u76ee\u524d\u5168\u7403\u6700\u6210\u529f\u4e4b\u751f\u7269\u88fd\u5291\u70ba\u816b\u7624\u58de\u6b7b\u56e0\u5b50TNF\u62ee\u6297\u5291\uff0c\u9069\u61c9\u75c7\u9ad8\u905412\u7a2e\uff0c\u6db5\u84cb\u5404\u7a2e\u4e3b\u8981\u6162\u6027\u767c\u708e\u6027\u75be\u75c5\u3002\u53e6\u5916\uff0c\u4ee5IL1\uff0cIL4\uff0cIL6\uff0cIL17\uff0cIL23\uff0cB\u7ec6\u80de\uff0cCTLA4\u70ba\u6a19\u9776\u7684\u751f\u7269\u88fd\u5291\uff0c\u4e5f\u6709\u591a\u7a2e\u5df2\u7d93\u4e0a\u5e02\u3002<\/p>\n\n\n\n

\u53f0\u7063\u73fe\u6709\u5df2\u4e0a\u5e02\u7684\u751f\u7269\u88fd\u5291<\/strong><\/strong><\/p>\n\n\n\n

\u81ea2001\u5e74\u8d77\uff0c\u53f0\u7063\u5df2\u6709\u591a\u7a2e\u85e5\u7269\u4e0a\u5e02\uff0c\u53ea\u8981\u7b26\u5408\u898f\u5b9a\uff0c\u53ef\u4ee5\u7533\u8acb\u5065\u4fdd\u5168\u984d\u7ed9\u4ed8\u3002\u5982:\u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\u7ed9\u4ed8\u689d\u4ef6\u70ba\u4f75\u7528\u5169\u7a2e\u50b3\u7d71DMARD\u85e5\u7269\u6cbb\u7642\u81f3\u5c11\u4e09\u500b\u6708\u7121\u6548\uff0cDAS28>5.1\u5c31\u53ef\u63d0\u51fa\u5065\u4fdd\u7ed9\u4ed8\u7533\u8acb\u3002\u50f5\u76f4\u6027\u810a\u690e\u708e\u7684\u7ed9\u4ed8\u689d\u4ef6\u70ba\u5169\u7a2e\u50b3\u7d71NSAID\u85e5\u7269\u6cbb\u7642\u81f3\u5c116\u500b\u6708\u7121\u6548\u3002<\/p>\n\n\n\n
\n \u82f1\u6587\u85e5\u540d\n <\/td>\n \u4f5c\u7528\u6a5f\u8f49\n <\/td>\n \u9069\u61c9\u75c7\n <\/td>\n \u5065\u4fdd\u7d66\u4ed8\n <\/td><\/tr>
\n Etanercept\n \uff08Enbrel\uff09\n <\/td>\n \u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\uff0c\u50f5\u76f4\u6027\u810a\u690e\u708e\uff0c\u4e7e\u766c\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\uff0c\u5e7c\u5e74\u578b\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Adalimumab\n (Humira)\n <\/td>\n \u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\uff0c\u50f5\u76f4\u6027\u810a\u690e\u708e\uff0c\u4e7e\u766c\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\uff0c\u6f70\u760d\u6027\u5927\u8178\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Golimumab\n (Simponi)\n <\/td>\n \u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\uff0c\u50f5\u76f4\u6027\u810a\u690e\u708e\uff0c\u4e7e\u766c\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Abatacept\n (Orencia)\n <\/td>\n T\u7d30\u80de\u56e0\u5b50TLA4\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Tocilizumab\n (Acetemra)\n <\/td>\n \u7d30\u80de\u6fc0\u7d20IL6\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Rituxtimab
\n (Mebthera)\n <\/td>		\n B\u7d30\u80deCD20\u6297\u539f\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
Belimumab <\/td>\n \u55ae\u682a\u6297\u9ad4\u8207B\u7d30\u80de\u4e0a\u7684BLyS\u53d7\u9ad4\u7684\u7d50\u5408\n <\/td>\n \u7d05\u6591\u6027\u72fc\u7621\n <\/td>\n \u7121\n <\/td><\/tr>
\n Tofacitinib\n <\/td>\n \u6291\u5236JAK\u6fc0\u9176\u4fe1\u865f\u6291\u5236\u57fa\u56e0\u7684\u8f49\u9304\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\uff0c\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\u3001\u6f70\u760d\u6027\u7d50\u8178\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Olumiant\n <\/td>\n \u9078\u64c7\u6027JAK1\u53caJAK2\u6291\u5236\u5291\n <\/td>\n \u985e\u98a8\u6ebc\u6027\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n certolizumab pegol\n (Cimzia)\n <\/td>\n \u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\n <\/td>\n \u985e\u98a8\u6fd5\u6027\u95dc\u7bc0\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n secukinumab\n (Cosentyx)\n <\/td>\n IL17\n <\/td>\n \u50f5\u76f4\u6027\u810a\u690e\u708e\n <\/td>\n \u6709\n <\/td><\/tr>
\n Ixekizumab\n (Taltz)\n <\/td>\n \u6297IL-17\u03b1 \u6297\u9ad4\n <\/td>\n \u6591\u584a\u72c0\u4e7e\u766c\n <\/td>\n \u6709\n <\/td><\/tr>
\n DUPIXENT\n (Dupixent)\n <\/td>\n \u6297IL-4\u8207IL-13\n <\/td>\n \u7570\u4f4d\u6027\u76ae\u819a\u708e\n <\/td>\n \u6709\n <\/td><\/tr><\/tbody><\/table>\n\n\n\n

\u751f\u7269\u76f8\u4f3c\u88fd\u5291<\/strong>Biosimilar<\/strong><\/p>\n\n\n\n

\u662f\u8fd1\u5e74\u751f\u7269\u88fd\u5291\u767c\u5c55\u8da8\u52e2\uff0c\u56e0\u6c28\u57fa\u9178\u5e8f\u5217\u8207\u539f\u751f\u85e5\u7269\u4e00\u6a23\uff0c\u53ea\u9700\u57f7\u884c\u7b2c\u4e00\u671f\u53ca\u7b2c\u4e09\u671f\u4e4b\u81e8\u5e8a\u8a66\u9a57\u5373\u53ef\u4e0a\u5e02\uff0c\u4e5f\u56e0\u6b64\u6e1b\u5c11\u85e5\u54c1\u958b\u767c\u7684\u6210\u672c\uff0c\u662f\u8fd1\u5e74\u6765\u5404\u5927\u85e5\u5ee0\u7684\u958b\u767c\u8da8\u52e2\u3002<\/p>\n\n\n\n

\u5c0f\u5206\u5b50\u514d\u75ab\u6a19\u9776\u85e5\u7269<\/strong><\/p>\n\n\n\n

\u4e5f\u7a31\u70ba(tsDMARD)\uff0c\u5df2\u4e0a\u5e02\u7684\u85e5\u7269\u70baJAK\u6291\u88fd\u5291:tofacitib\u3001baricitinib\uff0c\u5176\u4e3b\u8981\u512a\u9ede\u53e3\u670d\u65b9\u4fbf\uff0c\u900f\u904e\u7ec6\u80de\u5185\u7684\u8a0a\u606f\u50b3\u905e\uff0c\u53ef\u540c\u6642\u6291\u88fd\u591a\u500b\u6a19\u9776\u9ede\u3002\u81e8\u5e8a\u8a66\u9a57\u7d50\u679c\u986f\u793a\uff1b\u6709\u6548\u6027\u4e0d\u4e9e\u65bc\u751f\u7269\u88fd\u5291\u3002\u4e14\u6210\u672c\u8f03\u4f4e\uff0c\u4f7f\u7528\u65b9\u4fbf\uff0c\u672a\u4f86\u6709\u53ef\u80fd\u53d6\u4ee3\u751f\u7269\u88fd\u5291\u3002<\/p>\n\n\n\n

\u985e\u98a8\u6fd5\u6027\u95dc\u7bc0\u708e\u4e4b\u6cbb\u7642\u6307\u5357<\/strong><\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n
  1. \u50b3\u7d71DMARD\uff0c\u5e38\u898f\u5408\u6210(DMARDcsDMARd)\u7b2c\u4e00\u7dda\u6cbb\u7642\u7684\u514d\u75ab\u8abf\u7bc0\u5291\u3002<\/li>
  2. \u82e5\u75be\u75c5\u6d3b\u6027\u4e0d\u9ad8\uff0c\u5247\u9078\u7528\u594e\u5be7\u6cbb\u7642\uff1b\u53cd\u4e4b\u82e5\u6d3b\u6027\u8f03\u9ad8\u5247\u63a1\u7528\u81f3\u5584\u9320(MTX)\u3002<\/li>
  3. \u82e5\u7b2c\u4e00\u7dda\u85e5\u7269\u7121\u6548\uff0c\u5247\u5408\u4f75DMARD\u6cbb\u7642\uff0c\u6216\u76f4\u63a5\u4f7f\u7528TNF\u7b49\u6a19\u9776\u85e5\u7269\u642d\u914dMTX\u3002<\/li>
  4. \u5982\u518d\u7121\u6548\uff0c\u5247\u8f49\u63db\u4f7f\u7528\u4e0d\u540c\u7684\u751f\u7269\u88fd\u5291(\u751f\u7269\u88fd\u5291)\u6216\u5c0f\u5206\u5b50\u85e5\u7269\u3002<\/li><\/ol>\n\n\n\n

    \u91cd\u9ede\u63d0\u793a<\/strong><\/strong><\/p>\n\n\n\n

    1. \u898f\u5f8b\u7684\u751f\u6d3b\u578b\u614b\u3001\u58d3\u529b\u8abf\u9069\u3001\u904b\u52d5\u8207\u7761\u7720\u5c0d\u60a3\u8005\u5f88\u91cd\u8981\u3002<\/li>
    2. \u9075\u5f9e\u91ab\u751f\u6307\u793a\u670d\u85e5\uff0c\u82e5\u6709\u670d\u85e5\u4e0d\u9069\u61c9\u8207\u91ab\u5e2b\u5145\u4efd\u6e9d\u901a\uff0c\u907f\u514d\u81ea\u884c\u8abf\u6574\u85e5\u7269\u5291\u91cf\u3002<\/li>
    3. \u60a3\u8005\u61c9\u6642\u5e38\u95dc\u6ce8\u91ab\u9662\u91ab\u7642\u65b0\u77e5\uff0c\u82e5\u6709\u7591\u554f\u4e5f\u8a72\u548c\u91ab\u5e2b\u5145\u5206\u6e9d\u901a\uff0c\u826f\u597d\u7684\u91ab\u75c5\u95dc\u4fc2\u662f\u5c0d\u6297\u75be\u75c5\u7684\u95dc\u9375\u3002<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

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