JAK inhibitors and black box warnings: what is the future for JAK inhibitors?
JAK inhibitors and black box warnings: what is the future for JAK inhibitors?
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DOI：
10.1080/1744666x.2023.2249237
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发表时间：
2023-08
影响因子：
4.4
通讯作者：
Kate Tokareva;P. Reid;V. Yang;D. Liew;Alexander C Peterson;A. Baraff;J. Giles;Namrata Singh
中科院分区：
文献类型：
--
作者：
Kate Tokareva;P. Reid;V. Yang;D. Liew;Alexander C Peterson;A. Baraff;J. Giles;Namrata Singh
摘要引言Janus激酶抑制剂（JAKi）已经显著改善了各种自身免疫性疾病和骨髓增生性疾病的治疗。最近，人们开始关注它们在类风湿性关节炎患者中的安全性。在这里，我们提供了一个主要的当前和新兴的JAKI及其适应症的全面总结，解决最近的研究比较安全性，并提供深入了解他们的未来和使用。我们强调，在逐案基础上应用研究结果应考虑患者的年龄，合并症，正在考虑JAKI的疾病，疾病活动，JAKI靶点，患者可用的替代治疗方案以及JAKI的计划持续时间。专家意见风湿病学家习惯于开处方治疗，其中需要进行风险-受益评估，以及筛选和监测药物的安全性。因此，风湿病学家已经在应用特定的标准来有效地筛选和监测JAKI治疗的候选人。正在进行的研究将有助于澄清JAK和其他疗法之间差异安全性信号的任何机制，风险和疗效之间的平衡是什么，易感亚群是谁，以及不同JAK和不同适应症之间是否共享安全性信号。
ABSTRACT Introduction Janus kinase inhibitors (JAKi) have dramatically improved the treatment of various autoimmune and myeloproliferative disorders. Recently, concern has arisen regarding their safety in patients with rheumatoid arthritis. Areas covered Here, we provide a comprehensive summary of the major current and emerging JAKi and their indications, address recent studies on comparative safety, and provide insight into their future and use. We emphasize that the application of the research findings on a case-by-case basis should consider a patient’s age, comorbidities, disease for which JAKi is being considered, disease activity, the JAKi target(s), alternate treatment options available for the patient, and the planned duration of JAKi. Expert opinion Rheumatologists are used to prescribing therapies in which a risk-to-benefit assessment is required as well as to screening and monitoring the safety of medications. Thus, rheumatologists are already practiced in applying specific criteria to effectively screen and monitor patients who are candidates for JAKi therapy. Ongoing research will help to clarify any mechanisms underlying differential safety signals between JAK and other therapies, what the balance between risk and efficacy is, who the susceptible subpopulations are, and whether safety signals are shared between different JAKis and across indications.