title: Progress in understanding the safety and efficacy of Janus kinase inhibitors for treatment of rheumatoid arthritis.
abstract: BACKGROUND
  Treatment of rheumatoid arthritis (RA) has improved considerably following the advent of biologic disease-modifying anti-rheumatic drugs (DMARDs). However, these drugs require special storage and transportation. Janus kinase (JAK) inhibitors are oral synthetic DMARDs that inhibit the non-receptor tyrosine kinase family Janus kinase. Recently, many JAK inhibitors are being developed as new therapies for patients with RA.
  
  
  METHODS
  In this article, we mainly review the efficacy and safety of JAK inhibitors currently under investigation. Tofacitinib has already been approved in 43 countries except in the EU. Results of three JAK inhibitors (baricitinib, decernotinib, and peficitinib) in phase III are consistent with that of tofacitinib. Tofacitinib and baricitinib were partially effective in patients who had an inadequate response to biological DMARDs. Expert commentary: JAK kinase inhibitors provide a new therapeutic approach for rheumatoid arthritis. Meanwhile, further studies are needed to determine their risk-benefit ratio and the most appropriate patients suitable for such therapy.
authors.affiliation: a The First Department of Internal Medicine, School of Medicine , University of Occupational and Environmental Health, Japan , Kitakyushu , Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Iwata
authors.affiliation: a The First Department of Internal Medicine, School of Medicine , University of Occupational and Environmental Health, Japan , Kitakyushu , Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000284:Administration, Oral; D000818:Animals; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001384:Azetidines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006574:Heterocyclic Compounds, 2-Ring / Q000627:therapeutic use; D006801:Humans; D053613:Janus Kinase 1 / Q000037:antagonists & inhibitors*; D010880:Piperidines / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011687:Purines; D011720:Pyrazoles; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: C000596981:2-((2-(1H-pyrrolo(2,3-b)pyridin-3-yl)pyrimidin-4-yl)amino)-2-methyl-N-(2,2,2-trifluoroethyl)butanamide; D018501:Antirheumatic Agents; D001384:Azetidines; D006574:Heterocyclic Compounds, 2-Ring; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011687:Purines; D011720:Pyrazoles; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; C479163:tofacitinib; D053613:Janus Kinase 1; D014633:Valine; C000596027:baricitinib
keywords: B cell; JAK inhibitors; RA; T cell; dendritic cell