JAK Inhibitors in Moderate to Severe Rheumatoid Arthritis

Richard Conway, MB BCh, BAO, PhD


April 03, 2023

The past two decades saw the treatment of rheumatoid arthritis transformed by the introduction of biologic therapies targeting proinflammatory cytokines and immune cells.

Only around 30% of patients achieve complete remission with these drugs, however, and relapse often occurs after the cessation of treatment.

Dr Richard Conway, from Trinity College, Dublin, Ireland, explains that these therapies were followed by the introduction of treatments targeting the Janus kinase (JAK)/signal transducers and activators of transcription signaling pathway common to many cytokines.

All four currently available JAK inhibitors are associated with a benefit compared with methotrexate, the prior standard of care, but concerns remain about their safety.

Dr Conway notes that among the issues are an increased risk for herpes zoster, as well as cardiovascular events and cancer. Consequently, the use of JAK inhibitors to improve outcomes must be balanced against the potential risks.


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