Disciplina Reumatologia do Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP), Av. Dr. Arnaldo, 455 - 3° andar - Reumatologia, São Paulo, SP, CEP, 01246-903, Brasil.
Serviço de Reumatologia do Hospital, Universitário de Brasília (HUB/UnB), Brasília, Brazil.
Adv Rheumatol. 2021 Nov 24;61(1):70. doi: 10.1186/s42358-021-00228-x.
Rheumatoid arthritis (RA) is a chronic and autoimmune systemic inflammatory disease that can cause irreversible joint deformities, with increased morbidity and mortality and a significant impact on the quality of life of the affected individual. The main objective of RA treatment is to achieve sustained clinical remission or low disease activity. However, up to 40% of patients do not respond to available treatments, including bDMARDs. New therapeutic targets for RA are emerging, such as Janus kinases (JAKs). These are essential for intracellular signaling (via JAK-STAT) in response to many cytokines involved in RA immunopathogenesis. JAK inhibitors (JAKi) have established themselves as a highly effective treatment, gaining increasing space in the therapeutic arsenal for the treatment of RA. The current recommendations aim to present a review of the main aspects related to the efficacy and safety of JAKis in RA patients, and to update the recommendations and treatment algorithm proposed by the Brazilian Society of Rheumatology in 2017.
类风湿关节炎（RA）是一种慢性自身免疫性系统性炎症性疾病，可导致不可逆的关节畸形，发病率和死亡率增加，对患者的生活质量产生重大影响。RA 治疗的主要目标是实现持续的临床缓解或低疾病活动度。然而，高达 40%的患者对现有治疗方法（包括 bDMARDs）无反应。新的 RA 治疗靶点正在出现，如 Janus 激酶（JAKs）。这些激酶在细胞内信号转导（通过 JAK-STAT）中是必需的，以响应许多参与 RA 免疫发病机制的细胞因子。JAK 抑制剂（JAKi）已被证明是一种非常有效的治疗方法，在 RA 治疗的治疗武器库中获得了越来越多的应用空间。目前的建议旨在对 JAKi 在 RA 患者中的疗效和安全性的主要方面进行综述，并更新 2017 年巴西风湿病学会提出的建议和治疗算法。
