Abstract
The treatment of rheumatoid arthritis has made significant progress with the introduction of biologics directed against cytokines and immune cells. In recent years, there has been another beneficial shift in the treatment of rheumatoid arthritis.
Drugs interfering with intracellular signaling - in processes catalyzed by protein kinases, specifically Janus kinases (JAK), contributed to this. Three JAK inhibitors - tofacitinib, baricitinib and upadacitinib - have already been approved by the European Medicines Agency for the treatment of rheumatoid arthritis.
JAK inhibitors have a rapid onset of action, are effective in monotherapy similar to that in combination with methotrexate and are particularly effective in monotherapy than tumor necrosis factor inhibitors. As with biologic therapy, there is a greater risk of serious infections with JAK inhibitors.
Herpes zoster is more common compared with biologic therapy. In clinical practice, caution should be exercised in patients at increased risk of thromboembolic events.
In clinical practice, caution should be exercised in patients at increased risk of thromboembolic events. In this final work, the experience of clinical practice based on the national ATTRA registry will be discussed.