Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom; First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom.
J Allergy Clin Immunol. 2021 Oct;148(4):941-952. doi: 10.1016/j.jaci.2021.08.010. Epub 2021 Aug 24.
JAK inhibitors (JAKIs) are a new class of targeted therapy that have entered clinical practice for the treatment of immune-mediated rheumatic conditions. JAKIs can block the signaling activity of a variety of proinflammatory cytokines and therefore have the potential to mediate therapeutic benefits across a wide range of immune-mediated conditions. Several JAKIs are licensed, and many more are undergoing clinical trials. Here we provide a narrative review of the current and upcoming JAKIs for adult immune-mediated rheumatic and related conditions, with a specific focus on efficacy in rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, psoriasis, and inflammatory bowel disease. The overall safety profile of JAKIs appears largely comparable to that of existing biologic cytokine-targeting agents, particularly, TNF inhibitors, apart from risk of herpes zoster, which is increased for JAKIs. Importantly however, unresolved safety concerns remain, particularly relating to increased venous thromboembolism.
JAK 抑制剂（JAKIs）是一类新型的靶向治疗药物，已进入临床实践，用于治疗免疫介导的风湿性疾病。JAKIs 可阻断多种促炎细胞因子的信号转导活性，因此有可能在广泛的免疫介导性疾病中发挥治疗作用。目前已有几种 JAKIs 获得批准，还有更多的正在进行临床试验。本文对目前和即将推出的用于成人免疫介导性风湿性疾病及相关疾病的 JAKIs 进行了综述，重点介绍了其在类风湿关节炎、银屑病关节炎、脊柱关节炎、银屑病和炎症性肠病中的疗效。JAKIs 的总体安全性与现有生物细胞因子靶向药物（尤其是 TNF 抑制剂）的安全性大致相当，除了 JAKIs 会增加带状疱疹风险之外。然而，重要的是，仍存在未解决的安全性问题，特别是与静脉血栓栓塞风险增加有关。
