JAK-Hemmer bei adulter und juveniler Arthritis

ZUSAMMENFASSUNG

Die Therapie kindlicher rheumatischer Erkrankungen hat sich über die letzten dreißig Jahre entschieden verbessert durch die Einführung von wirksamen Medikamenten einschließlich biologischer DMARDS. Trotzdem ist die nächste Neuerung bereits in Sicht: ‚small molecules‘ in Tablettenform, die unterhalb der Ebene der Zytokin-Rezeptor-Interaktion mehrere Signalwege gleichzeitig hemmen können. In der Erwachsenenheilkunde haben diese Medikamente schon Einzug gehalten und sind inzwischen ein unverzichtbarer Bestandteil der rheumatologischen Behandlung. Für Kinder wird die Einführung des ersten Medikaments dieser Art noch in diesem Jahr erwartet. Nicht nur die in Studien gezeigte gute Wirksamkeit weckt hohe Erwartungen, auch die für Kinder nicht zu vernachlässigende Verbesserung durch die orale Gabe wird von Kinderrheumatologen dankbar angenommen werden. Weitere Verbesserungen des Wirkmechanismus dieser Medikamente haben dazu geführt, dass sich aktuell mehr als ein Dutzend Wirkstoffe in der ‚Pipeline‘ befinden; einschneidende Änderungen in der Therapie der rheumatoiden Arthritis und der juvenilen Arthritiden sind hier auf Jahre hinaus zu erwarten.

ABSTRACT

The treatment of pediatric rheumatic diseases has improved over the course of the last thirty years, mostly by introduction of effective medications including biologic DMARDs. However, more innovations are in sight: ‚small molecules‘ in the form of tablets, having their effect below the level of cytokine receptor interactions, who are able to block several signaling pathways at the same time. For adult rheumatology these medications have already entered the realm of treatment and are by now an essential component of anti-rheumatic pharmacological management. For children, the introduction of the first drug of this type is expected this year. Not only the good efficacy shown in studies raises expectations, but also the not inconsiderable benefit of oral application is gladly accepted by pediatric rheumatologists. Further improvement of the mechanism of action of these medications has led to more than a dozen drugs currently being in the pharmaceutical ‘pipeline’; significant changes to the treatment of rheumatoid arthritis and juvenile arthritides can be expected for years to come.

Schlüsselwörter

Juvenile idiopathische Arthritis - Therapie - kleine Moleküle

Keywords

Juvenile idiopathic arthritis - treatment - small molecules

Publication History

Article published online:
18 October 2021

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