JAK inhibitors for inflammatory bowel disease: recent advances

Sailish Honap*, Alexandra Agorogianni, Michael Colwill, Sonia Kalyanji Mehta, Fiona Donovan, Richard Pollok, Andrew Poullis, Kamal Patel

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Inflammatory bowel disease (IBD) commonly requires immunosuppressive treatments to induce and maintain durable remission. Janus kinase inhibitors (JAKis) are a novel group of orally administered, small molecule drugs that work by attenuating multiple cytokine signalling pathways to mediate dysregulated immune responses involved in the pathogenesis of IBD. Tofacitinib, filgotinib and upadacitinib have demonstrated efficacy against placebo and are licensed for the treatment of moderate to severe ulcerative colitis; upadacitinib is the only JAKi also currently approved for the treatment of Crohn’s disease. Safety concerns stratified by age have led to class-wide regulatory restrictions for JAKi use across all inflammatory diseases. It is important for gastroenterologists managing patients with IBD to be aware of the key pivotal trial outcomes, to identify appropriate patients in whom to commence a JAKi, and to understand the safety considerations and ways to mitigate these risks in the patients they treat. This review provides a contemporaneous overview of this emerging therapeutic class and provides a practical guide for healthcare practitioners for initiating and monitoring JAKi in IBD.
Original languageEnglish
Article number23102400
Pages (from-to)59-69
Number of pages11
JournalFrontline Gastroenterology
Volume15
Issue number1
Early online date14 Sept 2023
DOIs
Publication statusPublished - 14 Sept 2023

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