Selectivity of Janus Kinase Inhibitors in Rheumatoid Arthritis and Other Immune-Mediated Inflammatory Diseases: Is Expectation the Root of All Headache?

Drugs
Masayoshi Harigai, Suguru Honda

Abstract

Janus kinase (JAK) is a signal transducer and activator of a protein transcription system that transduces signals from cell surface cytokine and growth factor receptors to the nucleus. Recently developed JAK inhibitors (JAKinibs) inhibit JAKs non-selectively or selectively and down-regulate the effects of corresponding ligands (i.e. cytokines and growth factors). JAKinibs are efficacious against rheumatoid arthritis and other immune-mediated inflammatory diseases and are being increasingly prescribed clinically. Regarding safety, JAKinib use is associated with common or unique changes in laboratory parameters; however, incidence rates of serious adverse drug reactions (ADRs) associated with these changes are low. Opportunistic and other infections, including tuberculosis, are the most critical ADRs of treatment with JAKinibs, and screening and monitoring of patients should be carefully performed. Incidence rates of herpes zoster (HZ) in patients receiving JAKinibs are high in Japan and Korea, and modestly high in other countries. Filgotinib may not be associated with an elevated risk for HZ, but long-term safety data are lacking. Data from clinical development programmes and post-marketing surveillance have indicated no increas...Continue Reading

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Citations

Apr 29, 2021·Current Rheumatology Reports·Nurullah Akkoc, Muhammad A Khan
Jul 26, 2021·Clinical Drug Investigation·Esther S Kim, Susan J Keam
Aug 18, 2021·Expert Opinion on Pharmacotherapy·Christophe Richez, Marie-Elise Truchetet

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BETA
contraception

Clinical Trials Mentioned

NCT02092467

Software Mentioned

CORRNA

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