Gastroenterology Unit, Perugia General Hospital.
Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy.
J Clin Gastroenterol. 2019 Oct;53(9):635-640. doi: 10.1097/MCG.0000000000001250.
The treatment of ulcerative colitis (UC) is based on conventional therapies (aminosalicylates, corticosteroids, and immunosuppressants) and when these are ineffective, biologic drugs. However, in a substantial portion of patients undergoing treatment with biologic agents there is primary or secondary loss of response. Thus, new therapeutic options are been actively explored; among these, there is interest in the Janus kinase (JAK) inhibitors, small molecules that can be administered orally.
We carried out an extensive literature search concerning the effects of JAK inhibitors for the treatment of patients with UC.
Tofacitinib is the drug more extensively studied in this setting, and it was recently approved in Europe for the treatment of moderate to severe UC. The available data suggest that this drug can be effective in obtaining clinical and endoscopic remission in UC patients unresponsive to other treatments, even in those previously treated with biologic drugs. In addition, the drug was able to improve significantly the quality of life of these patients. There are still few data available for the treatment of UC with other JAK inhibitors.
The JAK inhibitors, in particular tofacitinib, are a new class of orally administered drugs effective for the treatment of UC. However, more studies are needed to ascertain the safety of tofacitinib in the long term and whether other compounds of this class may be equally effective.
溃疡性结肠炎（UC）的治疗基于传统疗法（氨基水杨酸盐、皮质类固醇和免疫抑制剂），当这些疗法无效时，会使用生物药物。然而，在接受生物制剂治疗的患者中，相当一部分存在原发性或继发性治疗失败。因此，人们正在积极探索新的治疗选择；其中，人们对 Janus 激酶（JAK）抑制剂，即可以口服的小分子药物，产生了兴趣。
我们对 JAK 抑制剂治疗 UC 患者的效果进行了广泛的文献检索。
托法替布是该领域研究最广泛的药物，最近已在欧洲获得批准，用于治疗中重度 UC。现有数据表明，对于其他治疗方法无应答的 UC 患者，甚至是那些先前已接受生物药物治疗的患者，该药物可有效获得临床和内镜缓解。此外，该药物还能显著改善这些患者的生活质量。对于其他 JAK 抑制剂治疗 UC 的资料仍较少。
JAK 抑制剂，特别是托法替布，是一类新的口服药物，对 UC 的治疗有效。然而，仍需要更多的研究来确定托法替布的长期安全性，以及该类其他化合物是否同样有效。
