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儿童中JAK抑制剂的范围:最近的证据和前进的道路
Narendra Kumar Bagri1, Christine Chew2,3, A V Ramanan4,5
1Division of Pediatric Rheumatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Paediatric drugs
|September 29, 2023
概括
简氏激酶 (JAK) 抑制剂在治疗儿童免疫中介性炎症疾病,特别是青少年异常性关节炎方面表现有前途. 虽然在儿科实践中通常是安全的,但对潜在危害的长期监测至关重要.
科学领域:
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
- 儿科 儿科 儿科
背景情况:
- 使用小分子的向治疗,包括Janus激酶 (JAK) 抑制剂,在过去十年中增加了.
- 像鲁克索利提尼布这样的JAK抑制剂最初被批准用于骨髓纤维化,现在用于各种免疫介导疾病.
- 有关与老年人 (>65岁) 中JAK抑制剂相关的心血管事件和恶性瘤存在担忧.
研究的目的:
- 审查JAK-STAT通路的免疫学.
- 讨论JAK抑制剂在免疫媒介炎症疾病 (IMIDs) 中的使用范围.
- 评估JAK抑制剂在儿科实践中的安全性.
主要方法:
- 对高质量的证据的审查,包括针对青少年异常性关节炎 (JIA) 的两项随机对照试验 (RCT).
- 对小儿IMID中JAK抑制剂的现有文献进行分析.
- 讨论免疫学方面和临床应用.
主要成果:
- 高质量的证据支持在对常规/生物疾病修饰药物耐药的JIA儿童中使用JAK抑制剂.
- 雅克抑制剂在其他儿科IMID中显示出潜力,包括全身发病的JIA和干扰性病变.
- 目前的文献表明,JAK抑制剂在儿童中具有可接受的安全性.
结论:
- 雅克抑制剂对特定的儿科免疫介导炎症疾病有效.
- 儿童的安全性似乎可以接受,但长期警至关重要.
- 扩大使用需要持续监测儿童群体的潜在不良事件.
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