关键词: font-family:", font-size:17px, background-color:#FFFFFF, ">JAK 抑制剂, 儿童, 风湿免疫性疾病, 血药浓度监测

Abstract: Janus kinase inhibitors provide a new therapeutic option distinct from conventional immunosuppressants and single target biologics for pediatric rheumatic and immune diseases by modulating multiple cytokine signals through the JAK-STAT pathway. Currently，there have been clear evidence of randomized controlled trials for tofacitinib and baricitinib in non-systemic juvenile idiopathic arthritis，while evidence for upadacitinib in polyarticular juvenile idiopathic arthritis is accumulating. In juvenile dermatomyositis，JAK inhibitors may be considered as individualized targeted therapeutic options for patients with refractory disease or specific phenotypes，particularly for children with prominent cutaneous involvement，marked type I interferon activation，or concomitant interstitial lung disease. In childhood onset systemic lupus erythematosus，their use remains mainly confined to refractory，relapsing，steroid-dependent or specific hyperinflammatory phenotypes. Besides，JAK inhibitors can also be used in type I interferonopathies and macrophage activation syndrome secondary to rheumatic and immune diseases.Clinical application of JAK inhibitors should be guided by stratified decision-making based on disease phenotype，inflammatory pathways，previous treatment response and individual risk profiles. In the future，their use in child patients should focus on monitoring of blood drug concentration and precise adjustment of individualized dose.

Key words: JAK inhibitors, child, rheumatic and immune disorders, blood drug concentration monitoring