Which medications in the drug class DMARDs, JAK Inhibitors are used in the treatment of Rheumatoid Arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

DMARDs, JAK Inhibitors

Janus kinase (JAK) pathway inhibitors consist of a group of intracellular tyrosine kinases that transmit signals from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoieses and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression.

Tofacitinib (Xeljanz, Xeljanz XR)

Tofacitinib is an oral JAK inhibitor. It is indicated as second-line treatment for moderate to severe active RA in patients with an inadequate response to or intolerance of MTX. Tofacitinib may be used as monotherapy or in combination with MTX or other nonbiologic DMARDs, but it should not be used in combination with biologic DMARDs or potent immunosuppressive agents (eg, azathioprine and cyclosporine). Tofacitinib is a JAK inhibitor that modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

Baricitinib (Olumiant)

Oral JAK inhibitor indicated for moderately to severely active RA as second-line treatment in adults who have had an inadequate response to one or more TNF-antagonists. It may be used as monotherapy or in combination with methotrexate or other nonbiologic DMARDs. It should not be used in combination with biologic DMARDs or potent immunosuppressive agents (eg, azathioprine or cyclosporine).

Upadacitinib (Rinvoq)

Indicated for moderately to severely active RA in adults who have had an inadequate response or are intolerant to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiological DMARDs.


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