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Janus kinase versus TNF inhibitors: where we stand today in rheumatoid arthritis

Aliki I Venetsanopoulou1, Paraskevi V Voulgari1, Alexandros A Drosos1

  • 1Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.

Expert Review of Clinical Immunology
|May 10, 2022
PubMed
Abstract

Insights

Tumor necrosis factor inhibitors (TNFi) and Janus kinase inhibitors (JAKi) offer significant benefits for rheumatoid arthritis (RA) patients. Further long-term safety data for JAK inhibitors are needed to optimize their risk-benefit profile.

Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) treatment has advanced with biologics and targeted therapies.
  • Tumor necrosis factor inhibitors (TNFi) were the first biologics, followed by Janus kinase inhibitors (JAKi).

Purpose of the Study:

  • To review the mechanism of action, clinical efficacy, and safety of TNFi versus JAKi in RA treatment.
  • To summarize current knowledge on these advanced RA therapies.

Main Methods:

  • Literature review of TNFi and JAKi mechanisms, efficacy, and safety.
  • Analysis of clinical trial data and expert recommendations.

Main Results:

  • Both TNFi and JAKi are effective as monotherapy or combined with conventional synthetic disease-modifying antirheumatic drugs.
  • JAKi have shown clinical benefits but raise concerns regarding safety and selectivity.

Conclusions:

  • TNFi and JAKi are recommended for moderate to severe RA by ACR and EULAR.
  • Long-term safety data are crucial for determining the optimal benefit-risk profile of JAKi.
Keywords:
JAK kinaseRheumatoid arthritisTNFaefficacyside effectstreatment

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