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巴瑞替尼:从类风湿关节炎到 COVID-19。

Baricitinib: From Rheumatoid Arthritis to COVID-19.

机构信息

Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Clin Pharmacol. 2021 Oct;61(10):1274-1285. doi: 10.1002/jcph.1874. Epub 2021 Jun 12.

Abstract

Baricitinib is a JAK1/2 inhibitor that was first approved for treating moderate to severe rheumatoid arthritis (RA) but that later showed considerable efficacy in the control of exaggerated inflammatory responses that occur in a wide range of diseases. There is a growing body of evidence, obtained from clinical trials and case reports, demonstrating clinical and paraclinical improvement in patients following administration of baricitinib including RA, systemic lupus erythematosus, psoriasis, atopic dermatitis, alopecia areata, interferon-mediated autoinflammatory diseases, graft-versus-host disease, diabetic kidney disease, and, recently, coronavirus disease-19. However, despite overall encouraging results, many adverse effects have been observed in baricitinib-treated patients, ranging from simple infections to increased risk of malignancies, particularly in long-term use. The significant efficacy of baricitinib, versus the probable adverse effects, urge further investigation before establishing it as a part of standard therapeutic protocols. Here, we have provided a review of the studies that have used baricitinib for treating various inflammatory disorders and summarized the advantages and disadvantages of its administration.

摘要

巴利昔替尼是一种 JAK1/2 抑制剂,最初被批准用于治疗中度至重度类风湿关节炎 (RA),但后来在控制广泛疾病中发生的过度炎症反应方面显示出相当大的疗效。越来越多的临床研究和病例报告的证据表明,巴利昔替尼治疗包括 RA、系统性红斑狼疮、银屑病、特应性皮炎、斑秃、干扰素介导的自身炎症性疾病、移植物抗宿主病、糖尿病肾病以及最近的 COVID-19 在内的多种疾病的患者的临床和临床前症状都有改善。然而,尽管总体结果令人鼓舞,但在接受巴利昔替尼治疗的患者中观察到许多不良反应,从简单的感染到恶性肿瘤风险增加,尤其是在长期使用时。巴利昔替尼的显著疗效与可能的不良反应相比,在将其确立为标准治疗方案的一部分之前,需要进一步的研究。在这里,我们对使用巴利昔替尼治疗各种炎症性疾病的研究进行了综述,并总结了其给药的优缺点。

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