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Review
. 2021 May 5;60(Suppl 2):ii31-ii38.
doi: 10.1093/rheumatology/keab265.

Clinical use of Jak 1 inhibitors for rheumatoid arthritis

Peter Nash  1
Affiliations
Review

Clinical use of Jak 1 inhibitors for rheumatoid arthritis

Peter Nash. Rheumatology (Oxford). .

Abstract

The uptake of Jak inhibitors in the RA space has been among the most rapid in rheumatology, based on the results of comprehensive clinical trial programmes of five agents. Newer generations of Jak inhibitors, like upadacitinib and filgotinib, target Jak 1 selectively with the aim of maximizing efficacy and to improve safety. This article will review the clinical significance of evidence on: (i) Jak 1 selectivity; (ii) efficacy from the SELECT and FINCH clinical trial programmes including patient intolerant or inadequately responding to MTX (MTX-IR) and other csDMARDs patients who are bDMARD-IR) and those using monotherapy when MTX is not tolerated or contraindicated and those treated when methotrexate naive; and (iii) safety from the clinical trial programmes of these two agents will be discussed.

Keywords: Jak 1 selectivity; efficacy; filgotinib; safety; upadacitinib.

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Figures

<sc>Fig</sc>. 1
Fig. 1
Jakinibs Australian Pharmaceutical Benefits Scheme
<sc>Fig</sc>. 2
Fig. 2
Jak selectivity Refer to numerous examples in other chapters of this supplement that show a jak selectivity figure.
<sc>Fig</sc>. 3
Fig. 3
MTX-IR Jakinib vs adalimumab (indirect comparison not head-to-head) 24 weeks
<sc>Fig</sc>. 4
Fig. 4
bDMARD-IR Jakinib (+ MTX) (indirect comparison not head-to-head) 24 weeks
<sc>Fig</sc>. 5
Fig. 5
Jakinib monotherapy (indirect comparison) corrected for MTX 24 weeks
<sc>Fig</sc>. 6
Fig. 6
Safety profile clinical trial exposure
See this image and copyright information in PMC

References

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    1. Parmentier JM, Voss J, Graff C. et al. In vitro and in vivo characterization of the JAK1 selectivity of upadacitinib (ABT-494). BMC Rheumatol 2018;2:23. - PMC - PubMed
    1. Taylor PC, Azeez MA, Kiriakidis S.. Filgotinib for the treatment of rheumatoid arthritis. Exp Opin Invest Drugs 2017;26:1181–7. - PubMed
    1. www.medicareaustralia.com.au.

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