JAK inhibitors (JAKIs) are a new class of targeted therapy that have entered clinical practice for the treatment of immune-mediated rheumatic conditions. JAKIs can block the signaling activity of a variety of proinflammatory cytokines and therefore have the potential to mediate therapeutic benefits across a wide range of immune-mediated conditions. Several JAKIs are licensed, and many more are undergoing clinical trials. Here we provide a narrative review of the current and upcoming JAKIs for adult immune-mediated rheumatic and related conditions, with a specific focus on efficacy in rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, psoriasis, and inflammatory bowel disease. The overall safety profile of JAKIs appears largely comparable to that of existing biologic cytokine-targeting agents, particularly, TNF inhibitors, apart from risk of herpes zoster, which is increased for JAKIs. Importantly however, unresolved safety concerns remain, particularly relating to increased venous thromboembolism.

JAK 抑制剂 (JAKI) 是一类新的靶向疗法，已进入临床实践，用于治疗免疫介导的风湿病。JAKI 可以阻断多种促炎细胞因子的信号活动，因此有可能在广泛的免疫介导条件下调节治疗效果。一些 JAKI 已获得许可，还有更多正在进行临床试验。在这里，我们对目前和即将推出的用于成人免疫介导的风湿病和相关疾病的 JAKI 进行叙述性回顾，特别关注类风湿性关节炎、银屑病关节炎、中轴性脊柱关节炎、银屑病和炎症性肠病的疗效。JAKI 的总体安全性似乎与现有的生物细胞因子靶向药物（尤其是 TNF 抑制剂）相当，除了带状疱疹的风险，JAKI 会增加。然而，重要的是，仍然存在未解决的安全问题，特别是与增加的静脉血栓栓塞相关的问题。