Uso de Inibidores de Janus Kinase no tratamento da Artrite Reumatoide / Use of Janus Kinase Inhibitors in the treatment of Rheumatoid Arthritis

Gabriel Monici Vieira, Débora Oliveira Piva, Giovanni Pereira Pio, Rafaela Lucas Damasceno, Ricardo de Villa Nova Japiassu, Anamaria Camargo Macedo, Luís Piva Júnior

Abstract


A artrite reumatoide é uma patologia autoimune relacionada a produção excessiva de citocinas inflamatórias, fator de necrose tumoral (TNF) e células T reativas, cursando com destruição articular progressiva, sinovite inflamatória crônica e manifestações em múltiplos órgãos. O tratamento evolucionário da patologia se resumia em drogas com ação anti-inflamatória e drogas antirreumáticas modificadoras de doença sistêmica biológica, as quais atuavam nos alvos de interleucinas inflamatórias e fatores de necrose tumorais (TNF). Apesar de uma boa remissão inicial, não eram totalmente eficazes e apresentavam vários efeitos colaterais. Com o advento do estudo sobre o genoma humano foi possível a identificação de quinases de sinalização, as quais fazem parte as Janus quinases (JAK), as mesmas desempenham a função de ativar as STAT´s e, consequentemente, seu transporte até o núcleo celular e a transdução de novos genes dependentes que influenciarão na fisiopatologia da AR. Medicamentos são estudados para inativação da ação das JAK´s, com o sucesso do Tofacitinibe, seletivo para JAK1 e JAK3, e com maior tolerabilidade e eficácia em comparação com os MMCD´s biológicos e Metotrexato. Fazem parte dessa nova classe as medicações Baricitinibe e Upadacitinibe. Esse estudo objetiva a análise comparativa entre medicamentos utilizados anteriormente para artrite reumatoide e os Inibidores de Janus Kinases. Iniciando uma breve exploração entre os principais fármacos que compõem a família dos Inibidores de Janus Kinases e a importância da nova possibilidade terapêutica para artrite reumatoide em comparação com as medicações anteriores, analisando a redução da morbidade e mortalidade dos pacientes acometidos. A presente revisão tratará de uma revisão narrativa da literatura a respeito da Artrite reumatoide, abrangendo seu quadro clínico, epidemiologia, bem como a diferença entre os tratamentos anteriormente empregados e o uso dos inibidores de Janus Kinases.


Keywords


Inibidores de Janus Kinase; Artrite Reumatoide; Treatment.

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DOI: https://doi.org/10.34119/bjhrv4n3-009

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