アブストラクト
Japanese
Title | アトピー性皮膚炎治療薬としてのJAK阻害薬 |
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Subtitle | 解説 : 免疫アレルギー疾患における分子標的薬 |
Authors | 樺島重憲1)2) |
Authors (kana) | |
Organization | 1)えがおの森こどもアレルギークリニック, 2)国立成育医療研究センター・アレルギーセンター |
Journal | 日本小児アレルギー学会誌 |
Volume | 37 |
Number | 5 |
Page | 519-526 |
Year/Month | 2023 / |
Article | 報告 |
Publisher | 日本小児アレルギー学会 |
Abstract | 「抄録」 : アトピー性皮膚炎の新規治療薬として, 主にJAK1およびJAK2を阻害するJAK阻害薬が注目されている. アトピー性皮膚炎の病態形成に関わるIL-4, IL-13, IL-22, TSLPといった複数のサイトカインの細胞内シグナル伝達を遮断することにより良好な治療効果を発揮する一方, JAK1およびJAK2以外のJAKファミリー分子への影響が少ないため, 全身投与を行っても重篤な副作用を生じにくいことが報告されている. 臨床的特徴の一つは, 投与開始後の効果発現が早いことである. 投与開始数日で掻痒感が軽減し, 長期に投与を継続しても効果の減弱は見られず, 投与終了後には比較的速やかに効果が消失する. 2023年6月現在, 本邦ではアトピー性皮膚炎の治療薬として3種類の経口JAK阻害薬が上市されているが, いずれも高価であり, その切れ味のよい特性を活かすなら, 中等症から重症の患者の治療を行う際の寛解導入に用いたり, 急性増悪時にステロイド外用薬への追加治療として用いたり, といった使用法が考えられる. |
Practice | 臨床医学:内科系 |
Keywords | アトピー性皮膚炎, 安全性, JAK阻害薬, 分子標的薬, 有効性, atopic dermatitis, efficacy, Janus kinase inhibitor, molecular-targeted drug, safety |
English
Title | JAK inhibitors for the treatment of atopic dermatitis |
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Subtitle | |
Authors | Shigenori Kabashima1)2) |
Authors (kana) | |
Organization | 1)Smile Forest Kid's Allergy Clinic, 2)Allergy Center, National Center for Child Health and Development |
Journal | The Japanese Journal of Pediatric Allergy and Clinical Immunology |
Volume | 37 |
Number | 5 |
Page | 519-526 |
Year/Month | 2023 / |
Article | Report |
Publisher | Japanese Society of Pediatric Allergy and Clinical Immunology |
Abstract | [Summary :] JAK inhibitors, which primarily inhibit JAK1 and JAK2, are garnering attention as new therapeutic agents for atopic dermatitis. These drugs exert a favorable therapeutic effect by blocking the intracellular signaling of multiple cytokines involved in the pathogenesis of atopic dermatitis, such as IL-4, IL-13, IL-22, and thymic stromal lymphopoietin. Additionally, they are unlikely to cause serious side effects, even when systemically administered, because they have a little effect on molecules in the JAK family except JAK1 and JAK2. One of the clinical characteristics of JAK inhibitors is their ability to rapidly exert their effect after their administration. The administration of JAK inhibitors can reduce the itching sensation within a few days. Notably, this effect does not diminish even in cases where they are administered for an extended period ; however, the effect quickly dissipates after discontinuation of their administration. Until June 2023, three orally administered JAK inhibitors were available in Japan to treat atopic dermatitis ; however, these inhibitors are expensive. Nevertheless, their high therapeutic responsiveness can be utilized for remission induction in patients with moderate to severe disease or used to deliver adjunctive therapy to topical steroids in acute exacerbations. |
Practice | Clinical internal medicine |
Keywords | atopic dermatitis, efficacy, Janus kinase inhibitor, molecular-targeted drug, safety |
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参考文献
- 1) Kabashima K. New concept of the pathogenesisof atopic dermatitis: interplay among the barrier, allergy, and pruritus as a trinity. J Dermatol Sci 2013 ; 70 : 3-11.
- 2) Langan SM, Irvine AD, Weidinger S. Atopic der-matitis. Lancet 2020 ; 396 : 345-360.
- 3) Howell MD, et al. Cytokine modulation of atopic dermatitis filaggrin skin expression. J Allergy Clin Immunol 2007 ; 120 : 150-155.
- 4) Zhuang L, et al. Evaluation of the effects of IL-22 on the proliferation and differentiation of kerati-nocytes in vitro. Mol Med Rep 2020 ; 22 : 2715-2722.
- 5) O'Shea JJ, et al. The JAK-STAT pathway: impact on human disease and therapeutic intervention. Annu Rev Med 2015 ; 66 : 311-328.
残りの13件を表示する
- 6) Luo Y, et al. JAK-STAT signaling in human dis-ease: From genetic syndromes to clinical inhibi-tion. J Allergy Clin Immunol 2021 ; 148 : 911-925.
- 7) Chovatiya R, Paller AS. JAK inhibitors in the treatment of atopic dermatitis. J Allergy Clin Im-munol 2021 ; 148 : 927-940.
- 8) Simpson EL, et al. Baricitinib in patients with moderate-to-severe atopic dermatitis and inade-quate response to topical corticosteroids: results from two randomized monotherapy phase III tri-als. Br J Dermatol 2020 ; 183 : 242-255.
- 9) Guttman-Yassky E, et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis(Measure Up 1 and Measure Up 2): results from two repli-cate double-blind, randomised controlled phase 3 trials. Lancet 2021 ; 397 : 2151-2168.
- 10) Simpson EL, et al. Efficacy and safety of abrocit-inib in adults and adolescents with moderate-to-severe atopic dermatitis(JADE MONO-1): a mul-ticentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet 2020 ; 396 : 255-266.
- 11) Silverberg JI, et al. Efficacy and safety of Abrocit-inib in Patients With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol 2020 ; 156 : 863-873.
- 12) Reich K, et al. Efficacy and safety of baricitinib combined with topical corticosteroids for treat-ment of moderate to severe atopic dermatitis: A randomized clinical trial. JAMA Dermatol 2020 ; 156 : 1333-1343.
- 13) Silverberg JI, et al. Upadacitinib plus topical corti-costeroids in atopic dermatitis: Week 52 AD Up study results. J Allergy Clin Immunol 2022 ; 149 : 977-987 e14.
- 14) Silverberg JI, et al. Long-term Efficacy of baricit-inib in adults with moderate to severe atopic der-matitis who were treatment responders or partial responders: An extension study of 2 randomized clinical trials. JAMA Dermatol 2021 ; 157 : 691-699.
- 15) Simpson EL, et al. Efficacy and safety of upadacit-inib in patients with moderate to severe atopic dermatitis: Analysis of follow-up data from the measure up 1 and measure up 2 randomized clini-cal trials. JAMA Dermatol 2022 ; 158 : 404-413.
- 16) Blauvelt A, et al. Abrocitinib induction, random-ized withdrawal, and retreatment in patients with moderate-to-severe atopic dermatitis: Re-sults from the JAK1 atopic dermatitis efficacy and safety(JADE) REGIMEN phase 3 trial. J Am Acad Dermatol 2022 ; 86 : 104-112.
- 17) Damsky W, King BA. JAK inhibitors in dermatol-ogy: The promise of a new drug class. J Am Acad Dermatol 2017 ; 76 : 736-744.
- 18) 日本皮膚科学会, 日本アレルギー学会. アトピー性皮膚炎診療ガイドライン 2021. 日本皮膚科学会誌 2021 ; 131 : 2691-2777.