Sicherheit von JAK-Inhibitoren

Zusammenfassung

Die zugelassenen Januskinase (JAK)-Inhibitoren Baricitinib und Tofacitinib haben bereits das Armamentarium hochwirksamer Therapien bei rheumatoider Arthritis, Psoriasis-Arthritis und Colitis ulcerosa erweitert. Als Alternative zu Biologika unterscheiden sie sich jedoch durch den Wirkmechanismus (Hemmung intrazellulärer Signalübertragung) und die orale Verfügbarkeit. Die Sicherheit ist jedoch ähnlich gut wie bei Biologika, am häufigsten kommen leichtgradige Infekte der oberen Atemwege vor. Verhältnismäßig seltene, aber spezifische Nebenwirkungen stellen Herpes-Zoster-Infektionen dar. Schwere Infektionen werden nur selten beobachtet. Nicht-infektiöse Nebenwirkungen beinhalten Laborwertveränderungen in Form von Zytopenien, Anstieg von Cholesterin (scheinbar ohne Erhöhung des kardiovaskulären Risikos), selten Leber- und Nierenwert-Erhöhungen sowie vermutlich ein erhöhtes Thromboembolie-Risiko bei bestimmten Risikokonstellationen.

Summary

The approved Janus kinase (JAK) inhibitors Baricitinib und Tofacitinib have already extended the armantarium of highly effective therapies in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ulcerative colitis. As alternatives to biologicals, JAK inhibitors however differ by their mode of action (inhibition of intracellular signaling) und oral availability. The safety is similarly favorable like already known for biologicals, with the most frequent adverse events being low-grade upper airway infections. Herpes zoster infections are rare, but specific for JAK inhibitors. Serious infections are very rare. Non-infectious adverse events include cytopenia, laboratory changes with increase of cholesterol (without changing the cardiovascular risk), very rare increases of transaminase and creatinine levels and as well as a potential risk of thromboembolic events in certain risk constellations.

Schlüsselwörter

JAK-Inhibitoren - Baricitinib - Tofacitinib - Sicherheit - Infektionen

Keywords

JAK-inhibitors - Baricitinib - Tofacitinib - safety - infections

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