Janus kinase inhibitors continue to show promise in a diverse range of indications, but administration of these drugs needs careful consideration of the benefits and risks. Among a plethora of publications in 2022, notable studies explored an important new indication and provided insights into safety concerns.
Key Advances
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The oral selective tyrosine kinase 2 inhibitor deucravacitinib reduced systemic lupus erythematosus disease activity across multiple domains, with an acceptable safety profile, in the phase II PAISLEY trial1.
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Cardiovascular and cancer risk was increased in patients treated with tofacitinib compared with a TNF inhibitor in the ORAL Surveillance study, which included patients with rheumatoid arthritis ≥50 years old and who had at least one cardiovascular risk factor2.
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Overall results of a meta-analysis combining post-marketing data from international sources suggest that the risk of venous thromboembolism is increased in patients treated with baricitinib compared with those treated with a TNF inhibitor3.
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References
Morand, E. et al. Deucravacitinib, a tyrosine kinase 2 inhibitor, in systemic lupus erythematosus: a phase 2, randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol. https://doi.org/10.1002/art.42391 (2022).
Ytterberg, S. R. et al. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N. Engl. J. Med. 386, 316–326 (2022).
Salinas, C. et al. Evaluation of VTE, MACE, and serious infections among patients with RA treated with baricitinib compared to TNFi: a multi-database study of patients in routine care using disease registries and claims databases. Rheumatol. Ther. https://doi.org/10.1007/s40744-022-00505-1 (2022).
Winthrop, K. L. & Cohen, S. B. Oral surveillance and JAK inhibitor safety: the theory of relativity. Nat. Rev. Rheumatol. 18, 301–304 (2022).
Paik, J. J. et al. Use of Janus kinase inhibitors in dermatomyositis: a systematic literature review. Clin. Exp. Rheumatol. https://doi.org/10.55563/clinexprheumatol/hxin6o (2022).
Watanabe, R. & Hashimoto, M. Perspectives of JAK inhibitors for large vessel vasculitis. Front Immunol. 13, 881705 (2022).
McGaugh, S., Kallis, P., De Benedetto, A. & Thomas, R. M. Janus kinase inhibitors for treatment of morphea and systemic sclerosis: A literature review. Dermatol Ther. 35, e15437 (2022).
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The author declares that he has received grants for research and clinical trials and honoraria for advice and lectures from Abbvie, Amgen, BMS, Gilead/Galapagos, Janssen, Lilly, Novartis, Pfizer and Roche.
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Nash, P. JAK inhibitors: new indication and emerging safety data in 2022. Nat Rev Rheumatol 19, 72–73 (2023). https://doi.org/10.1038/s41584-022-00891-4
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DOI: https://doi.org/10.1038/s41584-022-00891-4
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