Abstract
Janus kinases (JAK) are a group of enzymes (JAK 1, 2, 3 and Tyk2) that modulate signaling pathways involved in the pathogenesis of rheumatoid arthritis. JAK inhibitors are synthetic small molecules for oral use that belong to the group of targeted synthetic disease modifying antirheumatic drugs (tsDMARD).
Clinical trials with tofacitinib and baricitinib in treatment naive patients or irresponsive to conventional or biological DMARD patients with rheumatoid arthritis proved their fast therapeutic effect, improvement and sustained low disease activity, delayed radiographic progression and favorable safety profile. This lead to the approval for use in patients with rheumatoid arthritis and introduction to the treatment algorithm.
There are ongoing phase II and III clinical trials with selective and non-selective JAK inhibitors.