Janus激酶抑制劑在類風濕性關節炎的治療角色

The Role of Janus Kinase Inhibitors in the Treatment of Rheumatoid Arthritis

鄭傑夫(Jie-Fu Zheng)

《內科學誌》 33卷2期 (2022/04) Pp. 128-140

https://doi.org/10.6314/JIMT.202204_33(2).05

摘要

根據目前類風濕性關節炎的治療建議，當使用傳統合成抗風濕病藥物無法達到治療目標，尤其是當患者有不良預後因子時，則需要加上生物製劑或Janus激酶抑制劑來治療。Janus激酶抑制劑可抑制細胞內酵素並影響相關細胞激素的訊息傳遞。臨床研究已證實，對於經傳統合成抗風濕病藥物或生物製劑治療仍無法有效控制的類風濕性關節炎患者，Janus激酶抑制劑是有效的治療藥物，其治療效果並不亞於甚至可能優於生物製劑。然而由於Janus激酶抑制劑可能會增加感染、血栓、以及惡性腫瘤等風險，因此，在使用Janus激酶抑制劑前必須經過謹慎評估。

關鍵字

類風濕性關節炎（Rheumatoid arthritis） ； Janus激酶抑制劑（Janus kinase inhibitors）

並列摘要

According to the current treatment recommendations for rheumatoid arthritis, when the use of traditional synthetic anti-rheumatic drugs cannot achieve the treatment goals, especially when the patient has poor prognostic factors, it is necessary to add one of the biological agents or JAK inhibitors for treatment. JAK inhibitors can inhibit intracellular enzymes and affect the transmission of related cytokines. Clinical studies have confirmed that for patients with rheumatoid arthritis that cannot be effectively controlled by traditional synthetic anti-rheumatic drugs or biological agents, JAK inhibitors are effective therapeutic drugs, and their therapeutic effects are no less than or even better than biological agents. However, because JAK inhibitors may increase the risk of infection, thrombosis, and malignant tumors, they must be carefully evaluated before using.