[JAK inhibitors in the management of rheumatoid arthritis]

Janus kinase (JAK) inhibitors are part of the second-line therapeutic arsenal for patients with moderate to severe rheumatoid arthritis. The pivotal trials have demonstrated good efficacy, even in direct comparison to antirheumatic biotherapies. Their good efficacy is confirmed in observational studies, in particular with a good drug maintenance over time. Combination with conventional synthetic anti-rheumatic agents is probably less essential with JAK inhibitors than with some biotherapies, such as anti-TNFs. Registry studies have also confirmed the safety profile known from randomized trials, i.e. a safety profile generally close to that of antirheumatic biotherapies, with the exception of a slight increase in shingles cases.