2021 Volume 33 Issue 2 Pages 138-149
Rheumatoid arthritis（RA）is a chronic inflammatory autoimmune disease, which primarily targets synovial joints. Although the mechanism of disease onset of RA is still unclear, understanding of multiple cytokine signaling pathways has contributed to the clinical application of anti-TNF and anti-IL-6/ IL-6R antibodies for RA therapy with favorable clinical results. However, since some population of patients experiences inadequate efficacy and discontinuation of treatment due to adverse events with these drugs, the development of drugs with novel mechanisms had been expected.
CP-690,550（known as Tofacitinib）has been originally developed as an immunosuppressant for organ transplantation, thereafter approved for the treatment of RA in Japan as the first oral Janus kinase（JAK）inhibitor. Tofacitinib inhibits the type-I and type-II cytokine receptors /JAK-STAT pathway axis and reduces the overactivation of multiple cytokine signaling pathways involved in the pathogeneses of RA. In this review, we introduce the history of the development of tofacitinib and describe its clinical evidence among Japanese patients with RA.
