Chronic inflammatory diseases: do immunological patterns drive the choice of biotechnology drugs? A critical review.
Chronic inflammatory diseases represent a heterogeneous group of conditions that can affect practically any organ or system. An increasing number of biologic agents have been developed to selectively target the cell populations and signaling pathways involved in chronic inflammation, including cytokines, monoclonal antibodies and engineered receptors. This approach has been remarkably successful in alleviating some of the signs and symptoms of refractory autoimmune diseases. The use of this therapeutic strategy is likely to increase with the introduction of biosimilar agents. The different nature of these biological products makes the comparison of their pharmaceutical and clinical characteristics difficult, including safety and potency and these issues may be particularly relevant in the case of biosimilars. In addition, the heterogeneity of autoimmune diseases and of autoimmune patients, further adds to the complexity of choosing the right drug for each patient and predicting efficacy and safety of the treatment. In this review, we summarize actual knowledge about current biological agents and their use in autoimmune diseases, with a special emphasis for rheumatoid arthritis, inflammatory bowel diseases and psoriasis. The purpose of this analysis is to address the most critical issues raised by the rapid advancements in this field over recent years, and to acknowledge the potentially valuable gains brought about by the increasing availability of these new biologic agents.
Department of Molecular and Translational Medicine, University of Brescia , Brescia , Italy .
Silvano
S
Sozzani
Maria P
MP
Abbracchio
Vito
V
Annese
Silvio
S
Danese
Ornella
O
De Pità
Giovambattista
G
De Sarro
Sabatino
S
Maione
Ignazio
I
Olivieri
Aurora
A
Parodi
Piercarlo
P
Sarzi-Puttini
D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology; D015551:Autoimmunity; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D059451:Biosimilar Pharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000276:immunology; D058990:Molecular Targeted Therapy / Q000009:adverse effects; D011565:Psoriasis / Q000188:drug therapy / Q000276:immunology; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D001688:Biological Products; D059451:Biosimilar Pharmaceuticals; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha
Autoimmune diseases; anti-TNF agents; biosimilars; psoriasis; psoriatic arthritis