Jegatheeswaran Jehanya, Turk Matthew, Pope Janet E
University of Western Ontario, Schulich School of Medicine & Dentistry, Department of Medicine, London, ON, Canada.
Professor of Medicine, Division of Rheumatology, St. Joseph's Health Care & University of Western Ontario, London, Ontario, Canada.
Immunotherapy. 2019 Jun;11(8):737-754. doi: 10.2217/imt-2018-0178. Epub 2019 Apr 8.
Several Janus kinase (JAK) inhibitors, oral targeted disease-modifying drugs, will be approved for the treatment of rheumatoid arthritis (RA) and other diseases. This review compares and contrasts the efficacy of JAK inhibitors (tofacitinib, baricitinib, upadacitinib, filgotinib, peficitinib and decernotinib) in RA including: early RA methotrexate-naive patients, post methotrexate failure and post biologics. Trials in monotherapy, combination with disease modifying drugs such as methotrexate, and comparing with adalimumab in biologic-naive patients were studied. The efficacy is superior to methotrexate in naive patients and equal or superior to adalimumab depending on the drug and dose. There is a class effect of adverse events. Serious infections occur at a rate similar to other advanced therapies in RA, although more reactivation of herpes zoster occurs.
几种Janus激酶（JAK）抑制剂，即口服靶向病情改善药物，将被批准用于治疗类风湿性关节炎（RA）和其他疾病。本综述比较并对比了JAK抑制剂（托法替布、巴瑞替尼、乌帕替尼、非戈替尼、培非替尼和迪塞替尼）在RA中的疗效，包括：早期未使用甲氨蝶呤的RA患者、甲氨蝶呤治疗失败后以及生物制剂治疗后。研究了单药治疗试验、与甲氨蝶呤等病情改善药物联合使用的试验，以及在未使用过生物制剂的患者中与阿达木单抗进行比较的试验。在未使用过药物的患者中，其疗效优于甲氨蝶呤，并且根据药物和剂量的不同，疗效等同于或优于阿达木单抗。不良事件存在类效应。严重感染的发生率与RA的其他先进疗法相似，尽管带状疱疹的再激活发生率更高。
