Janus激酶抑制劑在類風溼性關節炎的應用與發展

10.6666/ClinMed.2017.79.4.040

洪明理；蔡長祐

rheumatoid arthritis(類風濕性關節炎) ； 合成疾病調節抗風溼藥物(synthetic disease-modifying anti-rheumatic drug, DMARD) ； Janus激酶(Janus kinase, Jak) ； Janus激酶抑制劑(Janus kinase inhibitor, Jakinib) ； 蛋白酪氨酸激酶(protein tyrosine kinases)

臨床醫學月刊

79卷4期（2017 / 04 / 28）

217 - 223

繁體中文

類風濕性關節炎(rheumatoid arthritis)為自體免疫疾病的一種，以破壞關節組織與滑膜發炎為其疾病主要特徵。類風濕性關節炎的治療，自啟用合成疾病調節抗風濕藥物(synthetic disease-modifying anti-rheumatic drug, DMARD)如methotrexate(MTX)與抗腫瘤壞死因子(anti-tumor necrosis factor, anti-TNF)之生物製劑後有長足的進步，減少患者關節組織的破壞，維持關節功能與改善患者的生活品質。現今類風濕性關節炎的治療目標有三項，第一項為臨床症狀緩解(clinical remission)、第二項長期保持臨床緩解期(maintenance)、第三項減少關節結構功能的損傷。但目前現有之生物製劑處方途徑侷限於靜脈注射與皮下給予，若口服劑型藥物研發成功，可增加病患服藥的便利性與藥物順從性。故現今類風濕性關節炎藥物研發的目標為口服小分子合成疾病調節抗風濕藥物。目前之小分子合成疾病調節抗風濕藥物機轉，以Janus激酶抑制劑(Janus kinase inhibitor, Jakinib)為主。Janus激酶(Janus kinase, Jak)在類風濕性關節炎病理機轉上扮演一重要角色。

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