Selective Janus kinase inhibitors come of age

• Published in: Nature reviews. Rheumatology Vol. 15; no. 2; pp. 74 - 75
• Main Authors: O’Shea, John J., Gadina, Massimo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2019; Nature Publishing Group
• Subjects: 692/699/1670/498; 692/700/565; Ankylosing spondylitis; Arthritis; Arthritis, Psoriatic - drug therapy; Arthritis, Rheumatoid - drug therapy; Cellular signal transduction; Clinical trials; Cytokines; Development and progression; Drug therapy; Enzyme inhibitors; Health aspects; Heterocyclic Compounds, 3-Ring - therapeutic use; Humans; Inflammation; Janus kinase; Janus Kinase Inhibitors - pharmacology; Janus Kinase Inhibitors - therapeutic use; Medicine; Medicine & Public Health; Patient outcomes; Psoriatic arthritis; Pyridines - therapeutic use; Rheumatic diseases; Rheumatology; Spondylitis; Triazoles - therapeutic use; Year in Review; United States
• ISSN: 1759-4790; 1759-4804
• DOI: 10.1038/s41584-018-0155-9

Janus kinase (JAK) inhibitors (jakinibs) that target downstream signalling by a large range of cytokines are effective in treating autoimmune and rheumatic diseases. Newer jakinibs that selectively inhibit individual JAKs and a narrower spectrum of cytokines have now been developed, but how do these inhibitors compare with existing drugs?
Key advances
Filgotinib, a JAK1-selective inhibitor, demonstrates efficacy in psoriatic arthritis with no unexpected safety signals
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Filgotinib is efficacious in patients with ankylosing spondylitis who did not respond to nonsteroidal anti-inflammatory drugs
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Two phase III trials demonstrate efficacy of upadacitinib, a selective JAK1, in RA
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