Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea.
Int J Mol Sci. 2021 Oct 20;22(21):11322. doi: 10.3390/ijms222111322.
For a significant proportion of patients with inflammatory bowel disease (IBD), primary non-response and secondary loss of response to treatment remain significant issues. Anti-tumor necrosis factor therapies have been licensed for use in IBD. Other disease-related pathways have been targeted as well, including the interleukin 12/23 axis and lymphocyte tracking. However, the need for parenteral administration and the associated costs of dispensing and monitoring all biologics remain a burden on healthcare systems and patients. Janus kinase inhibitors are small-molecule drugs that can be administered orally and are relatively inexpensive, thus offering an additional option for treating IBD. They have been shown to be effective in patients with ulcerative colitis (UC), but they are less effective in those with Crohn's disease (CD). Nonetheless, given the immune-system-based mechanism of these drugs, their safety profile remains a cause for concern. This article provides an overview of Janus kinase (JAK) inhibitors and new trends in the treatment of IBD.
对于相当一部分炎症性肠病(IBD)患者来说,原发性无应答和治疗继发性应答丧失仍然是一个重要问题。抗肿瘤坏死因子治疗已获准用于 IBD。其他与疾病相关的途径也已成为靶向治疗的目标,包括白细胞介素 12/23 轴和淋巴细胞追踪。然而,需要进行肠外给药,并且分配和监测所有生物制剂的相关费用仍然是医疗保健系统和患者的负担。Janus 激酶抑制剂是一种可以口服给药的小分子药物,相对便宜,因此为治疗 IBD 提供了另一种选择。它们已被证明对溃疡性结肠炎(UC)患者有效,但对克罗恩病(CD)患者的效果较差。尽管如此,鉴于这些药物的免疫系统为基础的作用机制,其安全性仍然令人担忧。本文概述了 Janus 激酶(JAK)抑制剂和 IBD 治疗的新趋势。