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Review
. 2020 Aug 1;14(Supplement_2):S755-S760.
doi: 10.1093/ecco-jcc/jjaa017.

JAK Inhibitors Safety in Ulcerative Colitis: Practical Implications

Manasi Agrawal  1 , Eun Soo Kim  1   2 , Jean-Frederic Colombel  1
Affiliations
Review

JAK Inhibitors Safety in Ulcerative Colitis: Practical Implications

Manasi Agrawal et al. J Crohns Colitis. .

Abstract

Janus kinase inhibitors [JAKi] are a new class of small molecule drugs that modulate inflammatory pathways by blocking one or more JAK receptors, and are increasingly being used in the treatment of immune-mediated diseases. Tofacitinib, a non-selective JAKi, is now approved for moderate-to-severe ulcerative colitis [UC] that is refractory or intolerant to tumour necrosis factor inhibitors [TNFi]. Whereas tofacitinib is associated with the advantages of oral administration, rapid onset of action, and lack of immunogenicity over TNFi, there are many safety considerations to take into account such as the risk of thromboembolism, infections, and hyperlipidaemia: each with specific nuances pertaining to prevention and monitoring strategies. Considerations such as pregnancy, breastfeeding, and history of malignancy also are to be navigated with utmost caution, given that very few data are available for guidance. With the use of JAKi in the real world progressively over time, safety implications will become more lucid, including caveats pertaining to JAK selectivity and gut-selective JAKi, as well as mechanistic data pertaining to adverse effects. This Viewpoint serves as a practical guide for clinicians managing inflammatory bowel disease [IBD] patients to navigate safety concerns around JAKi, including preventive and monitoring strategies.

Keywords: Inflammatory bowel diseases; JAK inhibitors; adverse effects; clinical care; drug safety; monitoring; preventive; tofacitinib; ulcerative colitis.

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Figures

Figure 1.
Figure 1.
Strategies to navigate safety concerns pertaining to tofacitinib for the treatment of moderate-to-severe ulcerative colitis. TNFi, tumour necrosis factor inhibitors.
See this image and copyright information in PMC

References

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