The dysregulation of the JAK–STAT pathway is associated with various immune disorders. Four JAK inhibitors have been approved for rheumatoid arthritis (RA), and numerous JAK inhibitors are currently being tested in phase II and III trials for the treatment of various autoimmune inflammatory diseases. In this narrative review, we elucidate the involvement of the JAK–STAT signaling pathway in the pathogenesis of connective tissue diseases (CTDs). We also discuss the efficacy of the first- and second-generation JAK inhibitors (tofacitinib, baricitinib, ruxolitinib, peficitinib, filgotinib, upadacitinib, solcitinib, itacitinib, decernotinib, R333, and pf-06651600) for CTDs including RA, systemic lupus erythematosus, dermatomyositis, systemic sclerosis, Sjögren’s syndrome, and vasculitis, based on laboratory and clinical research findings. JAK inhibitors have great potential for the treatment of various CTDs by reducing multiple cytokine production and suppressing inflammation, with the advantages of rapid onset in an oral formulation and decreased corticosteroid dependence and the associated adverse events, especially in refractory cases. We also highlight the safety of novel JAK inhibitors, which can cause opportunistic infections, especially viral infections. Being a very recent therapeutic option, information regarding the safety of JAK inhibitors during pregnancy and for pediatric use is limited. However, it is recommended that JAK inhibitors should be avoided in pregnant and breastfeeding women. More clinical data, especially on highly selective inhibitors, are required to judge the efficacy and safety of JAK inhibition in CTDs.

JAK-STAT 通路的失调与各种免疫疾病有关。四种 JAK 抑制剂已被批准用于治疗类风湿性关节炎 (RA)，许多 JAK 抑制剂目前正在 II 期和 III 期试验中进行测试，用于治疗各种自身免疫性炎症疾病。在这篇叙述性评论中，我们阐明了 JAK-STAT 信号通路在结缔组织病 (CTD) 的发病机制中的参与。我们还讨论了第一代和第二代 JAK 抑制剂（tofacitinib、baricitinib、ruxolitinib、peficitinib、filgotinib、upadacitinib、solcitinib、itacitinib、decernotinib、R333 和 pf-06651600）对 CTD 的疗效，包括 RA、系统性狼疮、红斑狼疮皮肌炎、系统性硬化症、干燥综合征和血管炎，基于实验室和临床研究结果。JAK 抑制剂通过减少多种细胞因子的产生和抑制炎症，具有治疗各种 CTD 的巨大潜力，其优点是口服制剂起效快，减少皮质类固醇依赖性和相关的不良事件，尤其是在难治性病例中。我们还强调了新型 JAK 抑制剂的安全性，它会导致机会性感染，尤其是病毒感染。作为最近的治疗选择，关于 JAK 抑制剂在怀孕期间和儿科使用的安全性的信息是有限的。但是，建议孕妇和哺乳期妇女应避免使用 JAK 抑制剂。需要更多的临床数据，尤其是高选择性抑制剂的数据来判断 JAK 抑制在 CTD 中的有效性和安全性。