Oregon Health &Science University, GH104, 3375 SW Terwilliger Blvd. Portland, Oregon, 97239, USA.
Nat Rev Rheumatol. 2017 Apr;13(4):234-243. doi: 10.1038/nrrheum.2017.23. Epub 2017 Mar 2.
Tofacitinib is the first Janus kinase (JAK) inhibitor commercially approved for the treatment of rheumatoid arthritis. This compound and a number of other JAK inhibitors are currently being tested in phase II and III trials for the treatment of a variety of autoimmune inflammatory diseases. Whereas a characteristic safety profile is emerging for some JAK inhibitors, differences between individual agents might emerge on the basis of distinct potency against their molecular targets. Similarly to biological therapy, JAK inhibition can lead to serious and opportunistic infections, and viral infections seem to be particularly frequent. Although no malignancy signals have been identified to date, long-term follow-up and further research are needed to understand the risk of malignancy associated with these compounds. As is the case for biologic agents, vaccination is important to mitigate the risks of these emerging therapies.
托法替尼是首个被商业批准用于治疗类风湿关节炎的 Janus 激酶 (JAK) 抑制剂。该化合物和许多其他 JAK 抑制剂目前正在进行 II 期和 III 期临床试验，以治疗多种自身免疫性炎症性疾病。虽然一些 JAK 抑制剂的特征性安全性概况正在出现，但由于对其分子靶标的不同效力，个别药物之间可能会出现差异。与生物治疗类似，JAK 抑制可能导致严重和机会性感染，病毒感染似乎特别频繁。尽管迄今为止尚未确定恶性肿瘤信号，但需要进行长期随访和进一步研究，以了解与这些化合物相关的恶性肿瘤风险。与生物制剂一样，接种疫苗对于降低这些新兴疗法的风险很重要。
