Howland Samantha, Deuring J Jasper, Zhou Xiaofeng, Chen Yan, Mota Licia Mh, Ungaro Ryan C
Pfizer Ltd, Tadworth, Surrey, United Kingdom.
Pfizer Inc, Rotterdam, The Netherlands.
Curr Ther Res Clin Exp. 2021;95:100639. doi: 10.1016/j.curtheres.2021.100639. Epub 2021 Jul 25.
Concerns have been raised that the risk of severe acute respiratory syndrome coronavirus 2 infection, or more severe or critical coronavirus disease 2019 (COVID-19), may be higher in immunocompromised individuals receiving immunomodulatory therapies compared with immunocompetent individuals. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, and polyarticular course juvenile idiopathic arthritis. To date, data on tofacitinib treatment during the COVID-19 pandemic are limited.
To summarize current understanding of the use of tofacitinib in adults during the COVID-19 pandemic, and discuss research questions that are yet to be addressed, to further inform the safe and effective use of tofacitinib in clinical practice.
We conducted a review of the literature (as of February 2021), to summarize the expert recommendations for the management of rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis in the context of COVID-19, and to assess the current data regarding the use of tofacitinib in adult patients during the pandemic.
Current recommendations for rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis state that tofacitinib treatment should be continued during the pandemic, except in cases of positive or presumed severe acute respiratory syndrome coronavirus 2 infection. However, limited data are available; analyses of data from international rheumatology and gastroenterology registries have suggested that tofacitinib may not be associated with an increased risk of hospitalization or treatment switching in adults with COVID-19.
Further assessment of tofacitinib use in patients with rheumatoid arthritis, psoriatic arthritis, or ulcerative colitis will be required to elucidate and establish the benefit:risk profile of tofacitinib during the current COVID-19 pandemic.
人们担心，与免疫功能正常的个体相比，接受免疫调节治疗的免疫功能低下个体感染严重急性呼吸综合征冠状病毒2或患更严重或危重型2019冠状病毒病（COVID-19）的风险可能更高。托法替布是一种口服Janus激酶抑制剂，用于治疗类风湿关节炎、银屑病关节炎、溃疡性结肠炎和多关节型幼年特发性关节炎。迄今为止，关于COVID-19大流行期间托法替布治疗的数据有限。
总结目前对COVID-19大流行期间成人使用托法替布的认识，并讨论有待解决的研究问题，以进一步指导托法替布在临床实践中的安全有效使用。
我们对文献（截至2021年2月）进行了综述，以总结在COVID-19背景下类风湿关节炎、银屑病关节炎和溃疡性结肠炎管理的专家建议，并评估大流行期间成人患者使用托法替布的现有数据。
目前针对类风湿关节炎、银屑病关节炎和溃疡性结肠炎的建议指出，在大流行期间应继续使用托法替布治疗，但严重急性呼吸综合征冠状病毒2感染呈阳性或疑似感染的情况除外。然而，可用数据有限；对国际风湿病学和胃肠病学登记处数据的分析表明，托法替布可能与COVID-19成人患者住院或更换治疗的风险增加无关。
需要进一步评估类风湿关节炎、银屑病关节炎或溃疡性结肠炎患者使用托法替布的情况，以阐明并确定在当前COVID-19大流行期间托法替布的获益-风险概况。
