与皮肤病学日常实践相关的Janus激酶抑制剂的不良反应

IF 3.8 4区 医学 Q1 DERMATOLOGY
Anika Rajput Khokhar, Kamran Ghoreschi, Julia Huynh
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引用次数: 0

摘要

自2011年在美国和2012年在欧盟使用以来,Janus激酶抑制剂(JAKi)越来越多地被接受为治疗皮肤疾病,如特应性皮炎、银屑病、银屑病关节炎、斑秃、慢性手部湿疹和白癜风。了解它们的作用机制和潜在的副作用是安全有效使用的必要条件。它们的半衰期短,需要每天给药,具有良好的可控性,由于起效快,不需要皮下或静脉注射,因此受到许多患者的欢迎。常见的副作用是上呼吸道感染以及水痘带状疱疹病毒再激活。在极少数情况下可能会发生严重感染,这可能会带来问题。在某些JAKi中已经描述了心血管事件风险的增加,因此对于有心血管风险的患者应优先选择替代治疗。在类风湿关节炎的研究中,观察到托法替尼增加了恶性肿瘤(支气管癌、淋巴瘤)的发病率。JAKi也与更严重的上皮性皮肤肿瘤进展有关。动物研究表明妊娠期有致畸作用。老年患者和风险增加的患者只有在仔细评估风险-收益后才能接受JAKi治疗。适当的初步检查和定期实验室监测是确保安全治疗的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Adverse effects of Janus kinase inhibitors with relevance for daily practice in dermatology

Adverse effects of Janus kinase inhibitors with relevance for daily practice in dermatology

Used since 2011 in the USA and 2012 in the EU, Janus kinase inhibitors (JAKi) are gaining increasing acceptance as a treatment for dermatological diseases such as atopic dermatitis, psoriasis, psoriatic arthritis, alopecia areata, chronic hand eczema and vitiligo. Knowledge of their mechanism of action and potential side effects is necessary for a safe and effective use. Their short half-life requires daily administration, enables good controllability and is appreciated by many patients due to the rapid onset of action and the absence of subcutaneous or intravenous injections.

Common side effects are upper respiratory tract infections as well as varicella zoster virus reactivations. Serious infections can occur in rare cases, which may take a problematic course. An increased risk of cardiovascular events has been described in certain JAKi, so alternative treatment should be preferred in patients at cardiovascular risk. In studies on rheumatoid arthritis, an increased incidence of malignancies (bronchial carcinoma, lymphoma) was observed with tofacitinib. JAKi have also been associated with more aggressive progression of epithelial skin tumors. Animal studies indicate teratogenic effects during pregnancy. Older patients and those at increased risk should only receive JAKi after careful risk-benefit assessment. Appropriate preliminary examinations and regular laboratory monitoring are necessary to ensure safe therapy.

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来源期刊
CiteScore
3.50
自引率
25.00%
发文量
406
审稿时长
1 months
期刊介绍: The JDDG publishes scientific papers from a wide range of disciplines, such as dermatovenereology, allergology, phlebology, dermatosurgery, dermatooncology, and dermatohistopathology. Also in JDDG: information on medical training, continuing education, a calendar of events, book reviews and society announcements. Papers can be submitted in German or English language. In the print version, all articles are published in German. In the online version, all key articles are published in English.
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