The rationale for Janus kinase inhibitors for the treatment of spondyloarthritis

Rheumatology (Oxford). 2019 Feb 1;58(2):197-205. doi: 10.1093/rheumatology/key070.

Abstract

The pathogenesis of SpA is multifactorial and involves a range of immune cell types and cytokines, many of which utilize Janus kinase (JAK) pathways for signaling. In this review, we summarize the animal and pre-clinical data that have demonstrated the effects of JAK blockade on the underlying molecular mechanisms of SpA and provide a rationale for JAK inhibition for the treatment of SpA. We also review the available clinical trial data evaluating JAK inhibitors tofacitinib, baricitinib, peficitinib, filgotinib and upadacitinib in PsA, AS and related inflammatory diseases, which have demonstrated the efficacy of these agents across a range of SpA-associated disease manifestations. The available clinical trial data, supported by pre-clinical animal model studies demonstrate that JAK inhibition is a promising therapeutic strategy for the treatment of SpA and may offer the potential for improvements in multiple articular and extra-articular disease manifestations of PsA and AS.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Psoriatic / drug therapy
  • Arthritis, Psoriatic / immunology
  • Cytokines / immunology
  • Humans
  • Janus Kinase Inhibitors / therapeutic use*
  • Janus Kinases / immunology
  • STAT Transcription Factors / immunology
  • Signal Transduction / immunology
  • Spondylarthritis / drug therapy*
  • Spondylarthritis / immunology

Substances

  • Antirheumatic Agents
  • Cytokines
  • Janus Kinase Inhibitors
  • STAT Transcription Factors
  • Janus Kinases