[类风湿性关节炎:对JAK抑制剂的新安全警告的评估]
1Klinische Immunologie, Rheumatologie Baden-Baden, Baden-Baden.
Deutsche medizinische Wochenschrift (1946)
|February 27, 2024
概括
简氏激酶抑制剂 (JAKi) 有效治疗类风湿性关节炎,但可能会增加心血管事件,血栓和恶性病的风险,特别是在老年人和吸烟者中. 新的建议旨在减轻这些JAK抑制剂风险.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 简氏激酶抑制剂 (JAKi) 对类风湿性关节炎 (RA) 有效,有时超过生物DMARDs.
- 批准的JAKi治疗RA包括托法西提尼布,巴里西提尼布,上达西提尼布和菲尔戈提尼布.
研究的目的:
- 评估JAK抑制剂 (JAKi) 在类风湿性关节炎 (RA) 治疗中的安全性.
- 分析有关托法西提尼布安全性的ORAL-SURVEILLANCE试验的发现.
- 讨论最新的欧洲药品管理局 (EMA) 关于JAKi处方的建议.
主要方法:
- 前性对照试验 (口腔监测) 将tofacitinib的安全性与TNF抑制剂进行比较.
- 分析与JAKi相关的心血管事件,血栓栓塞和恶性瘤风险.
- 审查EMA的人用医疗产品委员会 (CHMP) 的建议.
主要成果:
- 托法西替尼治疗显示,心血管事件,血栓栓塞和恶性瘤的风险增加.
- 在65岁以上的患者,现/前吸烟者,以及先前有心血管事件的患者中观察到更高的风险.
- 这些风险被认为是所有JAK抑制剂的类效应.
结论:
- 由于潜在的严重不良事件,JAK抑制剂需要谨慎的处方.
- 更新的EMA建议旨在减轻RA患者与JAKi治疗相关的风险.
- 风险分层对于在风湿性关节炎中安全有效地使用JAKi至关重要.
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