アブストラクト
| Title | 関節リウマチ治療におけるJAK阻害薬 |
|---|---|
| Subtitle | 特集 〈Clinical Science〉膠原病で期待される標的療法〜効果と今後への展望〜 |
| Authors | 岩井秀之 |
| Authors (kana) | |
| Organization | 東京医科歯科大学 膠原病・リウマチ内科 |
| Journal | 炎症と免疫 |
| Volume | 29 |
| Number | 4 |
| Page | 315-325 |
| Year/Month | 2021 / 7 |
| Article | 報告 |
| Publisher | 先端医学社 |
| Abstract | 関節リウマチ(RA)に対し, 5種類のJanus kinase (JAK)阻害薬が市販されている. それぞれのJAK選択性により想定される効果, 副作用といった限定的なものから, 実臨床でのランダム化比較試験(randomized controlled trial:RCT)を含む解析結果が得られるようになってきた. JAK間の直接比較, 変更といったデータはまだないが, 1. メトトレキサート(MTX)に効果不十分例, 2. 従来型合成抗リウマチ薬(conventional synthetic disease modified anti rheumatic drugs:csDMARDs)に効果不十分例, 3. 腫瘍壊死因子(tumor necrosis factor:TNF)阻害薬や非TNF-生物学的DMARDs(biological DMARDs:bDMARDs)に効果不十分例, 4. MTX未使用例でのJAK阻害薬単剤使用とMTX単剤使用の比較, 5. MTXに効果不十分例でのMTX併用でのアダリムマブとJAK阻害薬の比較, 6. JAK阻害薬単剤治療とJAK阻害薬とMTX併用との比較, それぞれにおいてJAK阻害薬の有効性が示されてきた. 肝腎代謝経路の違いによる使い分け, 血栓症や帯状疱疹などにも注意しながら, 寛解後減量も考慮した治療が望まれる. |
| Practice | 基礎医学・関連科学 |
| Keywords | 関節リウマチ, JAK阻害薬, JAK選択性, サイトカイン |
- 全文ダウンロード： 従量制、基本料金制の方共に935円(税込) です。
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