PDF(Pubmed)
Abstract：
Janus kinases (JAK)/Signal Transducer and Activator of Transcription (STAT) pathway is involved in pathophysiologic cascade of a notable number of rheumatic diseases. The development of JAK inhibitors has expanded treatment choices in rheumatoid arthritis (RA) with a sustained class-effect efficacy. Filgotinib is a novel selective inhibitor of JAK1 isoform licensed for use in RA and ulcerative colitis. In this review we aim to present an analysis of filgotinib\'s efficacy and drug-specific safety warnings. Patients with RA with or without concomitant conventional synthetic Disease-Modifying Antirheumatic Drugs (csDMARDs) (naïve or experienced) and those who have failed biologic Disease-Modifying Antirheumatic Drugs (bDMARDs) were examined in randomised clinical trials. Filgotinib was also tested against placebo, methotrexate, or adalimumab. Long-term extension trials provide insights for up to four years of continuous filgotinib administration. Beneficial effects are depicted in both disease activity parameters and quality of life indexes in moderate or severe RA with a longitudinal efficacy. In head-to-head comparison with adalimumab, filgotinib 200 mg was non-inferior. Adverse effects alerts are marked by the elevated risk of infectious adverse effects with the exception of herpes zoster infection, which has a low incidence.
摘要：
Janus激酶（JAK）/信号转导和转录激活因子（STAT）途径参与了许多风湿性疾病的病理生理级联反应。JAK抑制剂的开发扩大了类风湿性关节炎（RA）的治疗选择，具有持续的类效应功效。Filgotinib是一种新型的JAK1亚型选择性抑制剂，已获准用于RA和溃疡性结肠炎。在这篇综述中，我们旨在分析filgotinib的疗效和特定药物的安全性警告。在随机临床试验中检查了患有或不患有常规合成疾病修饰抗风湿药（csDMARDs）的RA患者（未经治疗或有经验）和那些生物疾病修饰抗风湿药（bDMARDs）失败的患者。Filgotinib还针对安慰剂进行了测试，甲氨蝶呤,或者阿达木单抗.长期延长试验为连续使用菲戈替尼四年提供了见解。在具有纵向疗效的中度或重度RA中，疾病活动参数和生活质量指标均显示了有益效果。在与阿达木单抗的头对头比较中，菲尔戈替尼200mg是非劣质的。除带状疱疹感染外，不良反应警报的特点是感染性不良反应的风险增加，发病率低。
