School of Medicine, Griffith University, Brisbane, Queensland, Australia.
Rheumatology (Oxford). 2021 May 5;60(Suppl 2):ii31-ii38. doi: 10.1093/rheumatology/keab265.
The uptake of Jak inhibitors in the RA space has been among the most rapid in rheumatology, based on the results of comprehensive clinical trial programmes of five agents. Newer generations of Jak inhibitors, like upadacitinib and filgotinib, target Jak 1 selectively with the aim of maximizing efficacy and to improve safety. This article will review the clinical significance of evidence on: (i) Jak 1 selectivity; (ii) efficacy from the SELECT and FINCH clinical trial programmes including patient intolerant or inadequately responding to MTX (MTX-IR) and other csDMARDs patients who are bDMARD-IR) and those using monotherapy when MTX is not tolerated or contraindicated and those treated when methotrexate naive; and (iii) safety from the clinical trial programmes of these two agents will be discussed.
基于五项综合临床试验计划的结果，Jak 抑制剂在 RA 领域的应用是风湿病学中最快的。新一代 Jak 抑制剂，如 upadacitinib 和 filgotinib，选择性靶向 Jak 1，旨在最大限度地提高疗效并提高安全性。本文将回顾关于以下方面的临床证据的重要性：（i）Jak 1 的选择性；（ii）来自 SELECT 和 FINCH 临床试验计划的疗效，包括对 MTX（MTX-IR）和其他 csDMARDs 不耐受或反应不足的患者（bDMARD-IR）以及在不耐受或禁忌使用 MTX 时使用单药治疗的患者，以及在使用甲氨蝶呤时未接受治疗的患者；（iii）这两种药物的临床试验计划的安全性。
