Januskinase-Inhibitoren in der Kinderrheumatologie

ZUSAMMENFASSUNG

Mit der Entwicklung von Januskinase (JAK)-Inhibitoren, einer neuen Klasse von „targeted synthetic (ts) disease modifying antirheumatic drugs (DMARDs)“, wurden innovative therapeutische Perspektiven geschaffen. Im Gegensatz zu Biologika, die als Antikörper oder Fusionsprotein ein einzelnes Zytokin extrazellulär, einen Zytokinrezeptor oder ein Oberflächenmolekül auf der Zelle blockieren, wirken JAK-Inhibitoren intrazellulär und vor allem breiter. Durch Inhibition von Tyrosinkinasen (JAK 1–3, Tyk 2) können sie den Signalweg von >50 Zytokinen unterbinden. Die JAK-Inhibitoren erweitern damit die Behandlungsoptionen bei rheumatischen Erkrankungen. Studien zu rheumatischen Erkrankungen bei Erwachsenen und erste Daten bei Kindern und Jugendlichen weisen auf eine im Vergleich zu Biologika gleichwertige oder sogar bessere Effektivität hin. In aktuell laufenden und zukünftigen Studien wird sich herausstellen, welche „Jakinibs“ die beste Wirkung-Nebenwirkungs-Relation aufweisen.

SUMMARY

The development of Janus kinase (JAK) inhibitors, a new class of “targeted synthetic (ts) DMARDs”, has opened new perspectives of treatment. Unlike biologics, which are antibodies or fusion proteins that block a single cytokine extracellularly or the corresponding cytokine receptor or a molecule at the cell surface, JAK inhibitors act intracellularly with particularly broader effect. By inhibiting tyrosine kinases (JAK 1–3, Tyk 2), they can stop the signaling pathway of >50 cytokines. JAK inhibitors thus expand treatment options for rheumatic diseases. Studies in rheumatic diseases in adults and initial data in children and adolescents indicate equivalent or even better efficacy compared to biologics. Current and future studies will determine which “Jakinibs” have the best efficacy/side-effect ratio.

Schlüsselwörter

Juvenile idiopathische Arthritis - Zytokine - Januskinase-Inhibitoren

Keywords

Juvenile idiopathic arthritis - cytokines - Janus kinase inhibitors

Publikationsverlauf

Artikel online veröffentlicht:
20. April 2021

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