12.adalimumab（Humira）為一種抗腫瘤壞死因子（anti-TNF）之單株抗體，最不建議用於治療下列何種疾 病？
(A)Crohn’s disease
(B)ankylosing spondylitis
(C)rheumatoid arthritis
(D)systemic lupus eryhematosus

Tumor necrosis factor (TNF)-α is not just a proinflammatory cytokine. It has also been proposed to be an immunoregulatory molecule that can alter the balance of T regulatory cells. Anti-TNF-α therapies have been provided clinical benefit to many patients and introduced for treating moderate to severe rheumatoid arthritis, Crohn's disease, and other chronic inflammatory disorders. However, their use also is accompanied by new or aggravated forms of autoimmunity, such as formation of autoantibodies, including antinuclear antibodies (ANAs), antidouble-stranded DNA (dsDNA) antibodies, and anticardiolipin antibodies (ACL). Systemic lupus erythematosus (SLE) is a disease with autoimmune disturbance and inflammatory damage. The role of TNF-α in human SLE is controversial. In summary, TNF-α exerts both deleterious tissue-damaging effects mainly through its pro-inflammatory activities and beneficial activities by dampening aggressive autoimmune responses. SLE is a disease with autoimmune disturbance and inflammatory damage, so blocking TNF-α in this autoimmune-prone chronic inflammatory disease may lead to different outcomes, depending on timing and duration of treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896679/ 

(A)Crohn’s disease 克隆氏症（ Crohn's Disease ），慢性腸道炎的一種
(B)ankylosing spondylitis   僵直性脊椎炎（Ankylosing Spondylitis） ，此外，僵直性脊椎炎和HLA-B27的遺傳有關
(C)rheumatoid arthritis  類風濕關節炎(Rheumatoid Arthritis 簡稱RA)
(D)systemic lupus eryhematosus 系統性紅斑性狼瘡，Systemic Lupus Erythematosus。 簡稱SLE 

adalimumab（Humira）為一種抗腫瘤壞死因子（anti-TNF）之單株抗體

適應症

類風濕性關節炎

Humira 適用於患有中度至重度類風濕性關節炎，並且曾經對一種或超過一種的 DMARDs 藥物有不適

當反應的成人病人，可減輕症狀與徵兆 (包括主要臨床反應和臨床緩解) 、抑制結構上損害的惡化。

Humira 可單獨使用也可以和 MTX 或其他 DMARDs 藥物併用。

乾癬性關節炎

適用於對疾病緩解型抗風濕藥物無療效之成人活動性與進行性乾癬性關節炎。

Humira 可單獨使用也可以和 MTX 或其他 DMARDs 藥物併用。

僵直性脊椎炎

適用於減輕患有活動性僵直性脊椎炎的病人之症狀與徵兆。

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克隆氏症

適用於對傳統治療無效之成人中度至重度克隆氏症 (CD)，可減輕症狀與徵兆及誘導與維持臨床緩解。

Humira 亦適用於對 infliximab 已經失去療效或無耐受性之成人中度至重度克隆氏症，可減輕症狀與徵

兆及誘導與維持臨床緩解。

乾癬

對其他全身性治療，包括 cyclosporine、MTX 或其他光化學療法無效、有禁忌或無法耐受之中度至重

度乾癬成人病人。

潰瘍性結腸炎

Humira 適用於對於皮質類固醇和/或 6- mercaptopurine (6-MP)或 azathioprine (AZA)等傳統治療無效、

或對這種療法不耐受或有醫療禁忌之中度至嚴重活動性潰瘍性結腸炎成人病人。

腸道貝西氏症

Humira 適用於治療對傳統治療無效之腸道貝西氏症 (Intestinal Behcet’s Disease) 病人。

化膿性汗腺炎

Humira 適用於對傳統全身性療法反應不佳的進行性中到重度化膿性汗腺炎(又可稱作acne inversa)之

成人病人。

葡萄膜炎

Humira 適用於治療對類固醇反應不佳，或不適合使用類固醇之成年病人的非感染性中段、後段和全

葡萄膜炎。