奥帕他替尼的标示外用途

Shivkar Amara, Ariana Sapoznik, S. Guénin, Nilesh Kodali, M. Lebwohl
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摘要

背景:Janus 激酶(JAK)抑制剂会干扰 JAK-STAT 信号通路,而 JAK-STAT 信号通路对调节炎症和免疫功能至关重要。值得注意的是,作为一种JAK抑制剂,乌达替尼(upadacitinib)已被越来越多地用作难治性炎症性疾病的治疗方法。研究方法使用关键词 "upadacitinib "结合 "标签外"、"皮肤科"、"皮肤 "或 "皮肤",在Pubmed和Clinical Trials.gov上进行了文献综述,时间为2021年10月1日至2023年10月1日。共审查了 941 篇文章,其中纳入了 50 篇文章。 结果: 通过系统检索,发现有20种不同的皮肤病在标示外使用了奥达替尼。这些病症中的大多数都通过积极减少与病症发病机制有关的炎症反应而得到了明显改善。据报道,该药物最常见的副作用是肌酸激酶升高、头痛、尿路感染和痤疮。此外,还应建议患者在接受达帕替尼治疗前考虑接种带状疱疹疫苗。结论奥达帕替尼在治疗难治性炎症性皮肤病、治疗耐药性瘙痒症和药物引起的皮肤反应方面具有潜在作用。需要进一步开展大规模对照临床试验,以评估奥达替尼的进一步适应症及其安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Off-Label Uses of Upadacitinib
Background: Janus Kinase (JAK) inhibitors interfere with the JAK-STAT signaling pathway, which is vital in regulating inflammation and immune function. Notably, upadacitinib, a JAK inhibitor, has been increasingly used as a treatment modality for refractory inflammatory diseases. Methods: A literature review was conducted on Pubmed and Clinical Trials.gov using the keywords “upadacitinib” combined with “off-label”, “dermatology”, “skin”, or “cutaneous” from October 1st, 2021, to October 1st, 2023. 941 articles were reviewed, and 50 articles were included.   Results:  The systematic search revealed 20 different dermatology conditions treated with off-label use of upadacitinib. Most of these conditions showed drastic improvement by actively decreasing the inflammatory response involved in the pathogenesis of that condition. The most common side effects reported for the medication were elevated creatine kinase, headaches, urinary tract infections, and acne. Patients should also be advised to consider the shingles vaccines prior to upadacitinib treatment. Conclusion: Upadacitinib shows potential utility in the treatment of refractory inflammatory dermatologic conditions, treatment-resistant pruritus, and medication-induced skin reactions. Further large-scale, controlled clinical trials are needed to evaluate the further indications of upadacitinib and its safety profile. 
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