Fleischmann Roy
a Medical Director, Metroplex Clinical Research Center , University of Texas Southwestern Medical Center , Dallas , TX , USA.
Expert Opin Pharmacother. 2017 Oct;18(14):1525-1533. doi: 10.1080/14656566.2017.1370453. Epub 2017 Aug 24.
Tofacitinib is a pan JAK inhibitor with specificity for JAK3 over JAK1 over JAK2, which is approved in many countries for the treatment of rheumatoid arthritis (RA), including the United States and the European Union, either as monotherapy or in combination with conventional synthetic disease modifying anti-arthritis drugs (csDMARDs). Phase 2, 3 and 4 clinical trials have investigated the efficacy and safety of tofacitinib given either as monotherapy or in combination with csDMARDs. Areas covered: This review reports the safety, clinical, functional, and radiographic efficacy, of tofacitinib used as monotherapy in the treatment of adult patients with RA reported in the prospective, double-blind, controlled randomized trials reported to date. One critical clinical question is whether tofacitinib monotherapy has similar efficacy as tofacitinib in combination with methotrexate (MTX); this question has recently been addressed. A literature search on tofacitinib monotherapy was carried out using the PubMed database up to July 2017. Expert opinion: Although tofacitinib plus MTX is statistically more clinically effective, tofacitinib monotherapy is effective in many patients with RA.
托法替布是一种泛JAK抑制剂，对JAK3的特异性高于JAK1和JAK2，在包括美国和欧盟在内的许多国家被批准用于治疗类风湿性关节炎（RA），可作为单一疗法或与传统合成抗风湿药物（csDMARDs）联合使用。2期、3期和4期临床试验研究了托法替布作为单一疗法或与csDMARDs联合使用的疗效和安全性。涵盖领域：本综述报告了在迄今为止报道的前瞻性、双盲、对照随机试验中，托法替布作为单一疗法治疗成年RA患者的安全性、临床、功能和影像学疗效。一个关键的临床问题是托法替布单一疗法是否与托法替布联合甲氨蝶呤（MTX）具有相似的疗效；这个问题最近已得到解决。使用PubMed数据库对截至2017年7月的托法替布单一疗法进行了文献检索。专家意见：虽然托法替布加MTX在统计学上临床效果更佳，但托法替布单一疗法对许多RA患者有效。
