Efficacy and safety of JAK inhibitors in rheumatoid arthritis: update for the practising clinician
Nat Rev Rheumatol 2024;20(2):101–115 DOI: 10.1038/s41584-023-01062-9
The observed benefit:risk ratio strongly favours JAKi use in the majority of patients, and HCPs should consider and adhere to guidance on high-risk patients where applicable. Szekanecz et al summarised the safety and efficacy of approved JAKis tofacitinib, baricitinib, upadacitinib, and filgotinib to aid in clinical decision making.
Recent regulatory guidance recommends caution or avoidance of JAKi therapy in high-risk patients. Clinical trials of approved JAKis observed no difference in the risk of MACEs, VTE, malignancies, or serious infections compared to bDMARDS. Older age, smoking status, CVD history and disease activity were associated with a heightened risk profile.
