Inhibitors of Janus kinases in the treatment of rheumatoid arthritis.
Authors:
M. Filková
Authors‘ workplace:
Revmatologický ústav, Praha
Published in:
Čes. Revmatol., 26, 2018, No. 3, p. 132-140.
Category:
Review Article
Overview
Inhibitors of Janus kinases (JAK) are synthetic small molecules for oral use targeting intracellular signalling pathways of many mediators with the essential role in the pathogenesis of rheumatoid arthritis (RA). Tofacitinib inhibits JAK3, JAK1 and to a lesser extent JAK2, whilst baricitinib preferentially interferes with JAK1 and JAK2. Their clinical efficacy was proven in several phase III clinical trials in RA patients either treatment naive or with inadequate response to conventional and biological disease modifying antirheumatic drugs. The clinical response was shown shortly after treatment initiation and low disease activity remained throughout the study. Both tofacitinib and baricitinib reduced radiographic progression. Some results showed either superiority or non-inferiority to methotreaxte or adalimumab. Both clinical efficacy and favourable safety profile enabled approval of tofacitinib and baricitinib for use in adult patients with RA with inadequate response to methotrexate. Tofacitinib has also been approved for treatment of patients with psoriatic arthritis and ulcerative colitis. Ongoing clinical trials with these and other JAK inhibitors will show their efficacy and safety in patients with RA or other inflammatory conditions.
Key words:
JAK, tofacitinib, baricitinib, rheumatoid arthritis, efficacy, safety
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Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
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