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Review
. 2023 Oct 23;12(20):6690.
doi: 10.3390/jcm12206690.

Janus Kinase Inhibitors in Rheumatoid Arthritis: An Update on the Efficacy and Safety of Tofacitinib, Baricitinib and Upadacitinib

Robert Harrington  1 , Patricia Harkins  1 , Richard Conway  1
Affiliations
Review

Janus Kinase Inhibitors in Rheumatoid Arthritis: An Update on the Efficacy and Safety of Tofacitinib, Baricitinib and Upadacitinib

Robert Harrington et al. J Clin Med. .

Abstract

Janus kinase inhibitors (JAKis) are the most recent new drug class to arrive to the market for rheumatoid arthritis (RA) treatment. While they have proven to be a very effective treatment option, there remains significant concern regarding the risk of cardiovascular events, thrombosis and malignancy, particularly given the findings of the post-marketing ORAL Surveillance study and FDA black box warnings. This article reviews the key findings of the most impactful cohort of studies and registry data since ORAL Surveillance. It also evaluates the role of JAKis in practice and offers guidance on risk stratifying patients and determining their suitability for a JAKi.

Keywords: JAK inhibitor; JAKi; Janus kinase inhibitior; MACE; ORAL surveillance; RA; VTE; efficacy; malignancy; rheumatoid arthritis; safety; thromboembolism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Timeline of JAK Inhibitor Approval [7].
Figure 2
Figure 2
Forest Plots of ACR Scores for the 3 FDA Approved JAKis [13,15,16].
Figure 3
Figure 3
ORAL Surveillance’s MACE Uncertainty [36].
Figure 4
Figure 4
A Tool for Approximate Risk Stratification in JAKi Prescribing.
See this image and copyright information in PMC

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