Alciati Alessandra, Di Carlo Marco, Siragusano Cesare, Palumbo Antonino, Masala Ignazio Francesco, Atzeni Fabiola
Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Humanitas Clinical and Research Center, Rozzano, Italy.
Rheumatology Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Jesi, Italy.
Expert Opin Biol Ther. 2022 Oct;22(10):1311-1322. doi: 10.1080/14712598.2022.2130243. Epub 2022 Oct 14.
The advent of biological disease-modifying anti-rheumatic drugs (bDMARDs) and, more recently, of Janus kinase inhibitors (JAKi) has had a major impact on the long-term outcomes of chronic inflammatory arthritis (IA). However, the persistence of pain, even in patients with a complete pharmacological control of peripheral inflammation, represents an important clinical challenge in the treatment of IA.
In this review, we provide an overview of possible mechanisms underlying pain in IA and its assessment, as well as the effects of bDMARDs and JAKi on pain management.
The overall data showed a good effect of bDMARDs and JAKi on pain, which is more pronounced for JAKi. However, it is challenging to distinguish the effect on the different types of pain (nociceptive, neuropathic, and nociplastic).
生物性改善病情抗风湿药物(bDMARDs)以及最近出现的 Janus 激酶抑制剂(JAKi)的问世,对慢性炎症性关节炎(IA)的长期预后产生了重大影响。然而,即使在外周炎症得到完全药物控制的患者中,疼痛的持续存在仍是 IA 治疗中的一项重要临床挑战。
在本综述中,我们概述了 IA 疼痛潜在的可能机制及其评估,以及 bDMARDs 和 JAKi 对疼痛管理的影响。
总体数据显示 bDMARDs 和 JAKi 对疼痛有良好效果,JAKi 的效果更为显著。然而,区分对不同类型疼痛(伤害性疼痛、神经性疼痛和神经病理性疼痛)的影响具有挑战性。