JAK inhibitors provide effective and convenient treatment options for arthritis patients

According to a new article in Rheumatology, published by Oxford University Press, JAK inhibitors, which doctors have used to treat patients with arthritis despite concerns about the effectiveness of such drugs, actually work quite well. In a multicenter retrospective study, Japanese researchers found that the drugs resulted in impressive remission rates in patients, most of whom choose to continue such treatment.

Rheumatoid arthritis is a common autoimmune disease characterized by chronic inflammation of the joint linings and results in progressive joint destruction and other systemic complications. The use of biologic disease-modifying drugs allows patients to enjoy achieving low disease activity and remission. But clinics must administer such medications via subcutaneous or intravenous routes, which is unpleasant for patients, and over time these medications often become less effective.

Recently, scientists have developed Janus kinase (JAK) inhibitors for the treatment of arthritis. Patients take such medications orally. Previous research has demonstrated the efficacy and safety of JAK inhibitors in randomized controlled trials. However, some researchers have questioned the potential efficacy of JAK inhibitors for widespread use by patients. In practice, doctors usually treat patients with JAK inhibitors, precisely because these patients have other health problems and conventional medications such as methotrexate are less effective for them. Real-world patients have distinctive characteristics compared to those recruited in randomized controlled trials.

In the current multicenter retrospective study, using data from 622 patients treated at seven major university hospitals in Japan, researchers compared the efficacy and safety of four common JAK inhibitors: tofacitinib, baricitinib, peficitinib, and upadacitinib.

The researchers here found that about one in three patients achieved remission, and three in four achieved at least low disease activity, with both figures representing impressive efficacy. They noted that more than 80% of patients were still taking the JAK inhibitors after six months.

They believe that this is especially relevant because with these oral medications there cannot be a failure of immunological secondary treatment, where medications are no longer effective because they cause adverse immune system responses in patients. Failure of secondary immunological treatment is common in patients treating their arthritis with drugs such as methotrexate.