Neri Benedetto, Mancone Roberto, Fiorillo Mariasofia, Schiavone Sara Concetta, Migliozzi Stefano, Biancone Livia
Gastroenterology Unit, Department of Systems Medicine, University "Tor Vergata" of Rome, 00133 Rome, Italy.
J Clin Med. 2024 Nov 27;13(23):7186. doi: 10.3390/jcm13237186.
Janus kinase-inhibitors (JAK-i) have recently been approved for treating patients with Ulcerative Colitis (); therefore, further information is needed, particularly regarding efficacy and safety. To provide a comprehensive review regarding the efficacy and safety of currently available JAK-i in UC. The PubMed and Scopus databases were considered, searching for 'JAK', 'JAK-inhibitor', 'Janus Kinases', 'Tofacitinib', 'Filgotinib', 'Upadacitinib', individually or in combination with 'IBD', 'Ulcerative Colitis', 'safety', 'efficacy', 'study' and 'trial'. The search was focused on full-text papers published in English, with no publication date restrictions. The efficacy and safety of JAK-i approved for treating patients with UC have been summarized. These included Tofacitinib, Filgotinib and Upadacitinib. Findings from both clinical trials and real-life studies in UC were reported, with particular regard to their efficacy in inducing clinical response and remission, steroid-free remission and endoscopic and histological healing. Overall, JAK-i proved to be effective and safe in selected subgroups of patients with UC. The rapid onset of action and the oral route of administration represent the most relevant characteristics of these drugs. Safety concerns using Tofacitinib in subgroups of patients (infections, hypercholesterolemia, venous thromboembolism and cardiovascular events) were initially raised. More recently, all JAK-i for UC showed an overall satisfactory safety profile. However, indication should be carefully given. The use of JAK-i UC is promising, although no predictive markers of response are currently available. Optimizing their use, as monotherapy or combined with other immunomodulators, may increase their efficacy in appropriately selected subgroups of patients with UC.
Janus激酶抑制剂（JAK-i）最近已被批准用于治疗溃疡性结肠炎（UC）患者；因此，需要更多信息，特别是关于疗效和安全性方面的信息。为了全面综述目前可用的JAK-i在UC中的疗效和安全性。检索了PubMed和Scopus数据库，搜索‘JAK’、‘JAK抑制剂’、‘Janus激酶’、‘托法替布’、‘非戈替尼’、‘乌帕替尼’，单独或与‘IBD’、‘溃疡性结肠炎’、‘安全性’、‘疗效’、‘研究’和‘试验’组合。搜索重点是英文发表的全文论文，无出版日期限制。总结了已批准用于治疗UC患者的JAK-i的疗效和安全性。这些药物包括托法替布、非戈替尼和乌帕替尼。报告了UC临床试验和真实世界研究的结果，特别关注它们在诱导临床反应和缓解、无类固醇缓解以及内镜和组织学愈合方面的疗效。总体而言，JAK-i在选定的UC患者亚组中被证明是有效和安全的。这些药物起效迅速且口服给药是其最相关的特点。最初有人对托法替布在某些患者亚组中的安全性提出担忧（感染、高胆固醇血症、静脉血栓栓塞和心血管事件）。最近，所有用于UC的JAK-i总体安全性良好。然而，用药指征应谨慎给出。JAK-i用于UC很有前景，尽管目前尚无反应预测标志物。优化其使用，作为单一疗法或与其他免疫调节剂联合使用，可能会提高其在适当选择的UC患者亚组中的疗效。
