Skip to main content

Advertisement

SpringerLink
Log in

JAK Inhibitors for Axial Spondyloarthritis: What does the Future Hold?

  • Spondyloarthritis (M Khan, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To discuss the potential role of JAK inhibitors (JAKis) as a new therapeutic class for the treatment of axial spondyloarthritis (axSpA, including ankylosing spondylitis [AS] and non-radiographic axSpA [nr-axSpA]).

Recent Findings

A phase III randomized controlled trial of tofacitinib (a “pan JAKi”) in patients with active AS was found to be superior to placebo in achieving the ASAS20 primary endpoint at week 16 (56.4% and 29.4%, p < 0.0001, phase II trials of AS). Upadacitinib, a JAK1 inhibitor, has also been evaluated in a phase III trial for its efficacy and safety in AS. The primary endpoint, ASAS40 at week 16, was reached by 52% of the patients randomized to upadacitinib and 26% of the patients receiving placebo (p = 0·0003). All the important secondary endpoints also improved with both agents. No new changes in their safety profile were noted. However, the more frequent occurrence of cardiovascular and cancer adverse events associated with tofacitinib than with TNFi observed in the very recent post-marketing “ORAL surveillance” safety study, the results of which were released on January 27, 2021, may lead to safety concerns swirling around the whole class of JAKis.

Summary

JAKis seem to be effective in treating signs and symptoms of AS but have not been studied in nr-axSpA. Both tofacitinib and upadacitinib have been pre-registered with the FDA for the treatment of AS. Upadacitinib has just recently received approval for this indication in the European Union..

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Wilson HM, Barker RN. Cytokines. eLS. 2013. https://doi.org/10.1002/9780470015902.a0000929.pub3.

  2. Zhang H, Shi N, Diao Z, Chen Y, Zhang Y. Therapeutic potential of TNFα inhibitors in chronic inflammatory disorders: past and future. Genes & Diseases. 2020. https://doi.org/10.1016/j.gendis.2020.02.004.

  3. Goldbach-Mansky R. Blocking interleukin-1 in rheumatic diseases. Ann N Y Acad Sci. 2009;1182:111–23. https://doi.org/10.1111/j.1749-6632.2009.05159.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Choy EH, De Benedetti F, Takeuchi T, Hashizume M, John MR, Kishimoto T. Translating IL-6 biology into effective treatments. Nat Rev Rheumatol. 2020;16(6):335–45. https://doi.org/10.1038/s41584-020-0419-z.

    Article  CAS  PubMed  Google Scholar 

  5. Ruiz de Morales JMG, Puig L, Dauden E, et al. Critical role of interleukin (IL)-17 in inflammatory and immune disorders: an updated review of the evidence focusing in controversies. Autoimmun Rev. 2020;19(1):102429. https://doi.org/10.1016/j.autrev.2019.102429.

    Article  CAS  PubMed  Google Scholar 

  6. Lyakh L, Trinchieri G, Provezza L, Carra G, Gerosa F. Regulation of interleukin-12/interleukin-23 production and the T-helper 17 response in humans. Immunol Rev. 2008;226:112–31. https://doi.org/10.1111/j.1600-065X.2008.00700.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Deodhar A, Gensler LS, Sieper J, et al. Three multicenter, randomized, double-blind, placebo-controlled studies evaluating the efficacy and safety of ustekinumab in axial spondyloarthritis. Arthritis Rheumatol. 2019;71(2):258–70. https://doi.org/10.1002/art.40728.

    Article  CAS  PubMed  Google Scholar 

  8. Baeten D, Ostergaard M, Wei JC, et al. Risankizumab, an IL-23 inhibitor, for ankylosing spondylitis: results of a randomised, double-blind, placebo-controlled, proof-of-concept, dose-finding phase 2 study. Ann Rheum Dis. 2018;77(9):1295–302. https://doi.org/10.1136/annrheumdis-2018-213328.

    Article  CAS  PubMed  Google Scholar 

  9. Haibel H, Rudwaleit M, Listing J, Sieper J. Open label trial of anakinra in active ankylosing spondylitis over 24 weeks. Ann Rheum Dis. 2005;64(2):296–8. https://doi.org/10.1136/ard.2004.023176.

    Article  CAS  PubMed  Google Scholar 

  10. Sieper J, Braun J, Kay J, et al. Sarilumab for the treatment of ankylosing spondylitis: results of a Phase II, randomised, double-blind, placebo-controlled study (ALIGN). Ann Rheum Dis. 2015;74(6):1051–7. https://doi.org/10.1136/annrheumdis-2013-204963.

    Article  CAS  PubMed  Google Scholar 

  11. Sieper J, Porter-Brown B, Thompson L, Harari O, Dougados M. Assessment of short-term symptomatic efficacy of tocilizumab in ankylosing spondylitis: results of randomised, placebo-controlled trials. Ann Rheum Dis. 2014;73(1):95–100. https://doi.org/10.1136/annrheumdis-2013-203559.

    Article  CAS  PubMed  Google Scholar 

  12. Banerjee S, Biehl A, Gadina M, Hasni S, Schwartz DM. JAK-STAT signaling as a target for inflammatory and autoimmune diseases: current and future prospects. Drugs. 2017;77(5):521–46. https://doi.org/10.1007/s40265-017-0701-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Clark JD, Flanagan ME, Telliez JB. Discovery and development of Janus kinase (JAK) inhibitors for inflammatory diseases. J Med Chem. 2014;57(12):5023–38. https://doi.org/10.1021/jm401490p.

    Article  CAS  PubMed  Google Scholar 

  14. Morris R, Kershaw NJ, Babon JJ. The molecular details of cytokine signaling via the JAK/STAT pathway. Protein Sci. 2018;27(12):1984–2009. https://doi.org/10.1002/pro.3519.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Schwartz DM, Kanno Y, Villarino A, Ward M, Gadina M, O'Shea JJ. JAK inhibition as a therapeutic strategy for immune and inflammatory diseases. Nat Rev Drug Discov. 2017;16(12):843–62. https://doi.org/10.1038/nrd.2017.201.

    Article  CAS  PubMed  Google Scholar 

  16. Ghoreschi K, Laurence A, O'Shea JJ. Janus kinases in immune cell signaling. Immunol Rev. 2009;228(1):273–87. https://doi.org/10.1111/j.1600-065X.2008.00754.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Baker KF, Isaacs JD. Novel therapies for immune-mediated inflammatory diseases: what can we learn from their use in rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, psoriasis, Crohn’s disease and ulcerative colitis? Ann Rheum Dis. 2018;77(2):175–87. https://doi.org/10.1136/annrheumdis-2017-211555.

    Article  CAS  PubMed  Google Scholar 

  18. Villarino AV, Kanno Y, O'Shea JJ. Mechanisms and consequences of Jak-STAT signaling in the immune system. Nat Immunol. 2017;18(4):374–84. https://doi.org/10.1038/ni.3691.

    Article  CAS  PubMed  Google Scholar 

  19. Reddy V, Cohen S. JAK inhibitors: what is new? Curr Rheumatol Rep. 2020;22(9):50. https://doi.org/10.1007/s11926-020-00931-6.

    Article  CAS  PubMed  Google Scholar 

  20. Deodhar A, Yu D. Switching tumor necrosis factor inhibitors in the treatment of axial spondyloarthritis. Semin Arthritis Rheum. 2017;47(3):343–50. https://doi.org/10.1016/j.semarthrit.2017.04.005.

    Article  CAS  PubMed  Google Scholar 

  21. Sieper J, Deodhar A, Marzo-Ortega H, et al. Secukinumab efficacy in anti-TNF-naive and anti-TNF-experienced subjects with active ankylosing spondylitis: results from the MEASURE 2 Study. Ann Rheum Dis. 2017;76(3):571–92. https://doi.org/10.1136/annrheumdis-2016-210023.

    Article  CAS  PubMed  Google Scholar 

  22. van der Heijde D, Deodhar A, Wei JC, et al. Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study. Ann Rheum Dis. 2017;76(8):1340–7. https://doi.org/10.1136/annrheumdis-2016-210322.

    Article  CAS  PubMed  Google Scholar 

  23. Deodhar A, Sliwinska-Stanczyk P, Xu H, et al. Tofacitinib for the treatment of adult patients with ankylosing spondylitis: primary analysis of a phase 3, randomized, double-blind, placebo-controlled study [abstract]. Arthritis Rheumatol. 2020;72(suppl 10).

  24. •• van der Heijde D, Song IH, Pangan AL, et al. Efficacy and safety of upadacitinib in patients with active ankylosing spondylitis (SELECT-AXIS 1): a multicentre, randomised, double-blind, placebo-controlled, phase 2/3 trial. Lancet. 2019;394(10214):2108–17. https://doi.org/10.1016/S0140-6736(19)32534-6This multicentre, randomised, double-blind, placebo-controlled, two-period, parallel-group, phase 2/3 study shows that upadacitinib is effective in supressing the signs and symptoms of AS, and also the inflammation in the spine and sacroiliac joints on MRI.

    Article  PubMed  Google Scholar 

  25. • van der Heijde D, Baraliakos X, Gensler LS, et al. Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active ankylosing spondylitis (TORTUGA): results from a randomised, placebo-controlled, phase 2 trial. Lancet. 2018;392(10162):2378–87. https://doi.org/10.1016/S0140-6736(18)32463-2This article presents the results of the Phase II TORTUGA trial which investigated the efficacy and safety of filgotinib for the treatment of patients with active ankylosing spondylitis and suggests that filgotinib shows good efficacy across a wide range of parameters relevant for ankylosing spondylitis.

    Article  PubMed  Google Scholar 

  26. van der Heijde D, Song IH, Pangan A, et al. Efficacy and safety of upadacitinib in a randomized, double-blind, placebo-controlled, multicenter phase 2/3 clinical study of patients with active ankylosing spondylitis. Arthritis & Rheumatology. 2019;71.

  27. Abbvie Inc. RINVOQTM (upadacitinib): US prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211675s000lbl.pdf.

  28. Abbvie Inc. RINVOQ (upadacitinib). EPAR-Product Information 2021. https://www.ema.europa.eu/en/documents/product-information/rinvoq-epar-product-information_en.pdf. Accessed April 10 2021.

  29. Deodhar A, van der Heijde D, Sieper J, et al. Efficacy and safety of upadacitinib in patients with active ankylosing spondylitis: 1-year results from a randomized, double-blind, placebo-controlled study with open-label extension [abstract]. Arthritis Rheumatol. 2020;72(Suppl 10).

  30. Gilead and Galapagos Announce New Commercialization and Development Agreement for Jyseleca® (Filgotinib). Press release. December 15, 2020. https://www.gilead.com/news-and-press/press-room/press-releases/2020/12/gilead-and-galapagos-announce-new-commercialization-and-development-agreement-for-jyseleca-filgotinib. Accessed 20 Dec 2020.

  31. Cohen SB, Tanaka Y, Mariette X, et al. Long-term safety of tofacitinib up to 9.5 years: a comprehensive integrated analysis of the rheumatoid arthritis clinical development programme. RMD Open. 2020;6(3). https://doi.org/10.1136/rmdopen-2020-001395.

  32. Cohen SB, Van Vollenhoven R, Curtis JR, et al. Safety profile of upadacitinib up to 3 years of exposure in patients with rheumatoid arthritis [abstract]. Arthritis Rheumatol. 2020;72(Suppl 10).

  33. Winthrop KL. The emerging safety profile of JAK inhibitors in rheumatic disease. Nat Rev Rheumatol. 2017;13(4):234–43. https://doi.org/10.1038/nrrheum.2017.23.

    Article  CAS  PubMed  Google Scholar 

  34. Angelini J, Talotta R, Roncato R, et al. JAK-inhibitors for the treatment of rheumatoid arthritis: a focus on the present and an outlook on the future. Biomolecules. 2020;10(7). https://doi.org/10.3390/biom10071002.

  35. • Sunzini F, McInnes I, Siebert S. JAK inhibitors and infections risk: focus on herpes zoster. Ther Adv Musculoskelet Dis. 2020;12:1759720X20936059. https://doi.org/10.1177/1759720X20936059A concise review which presents the current evidence on the principal JAK inhibitors and their association with viral infections.

  36. Harigai M, Honda S. Selectivity of Janus kinase inhibitors in rheumatoid arthritis and other immune-mediated inflammatory diseases: is expectation the root of all headache? Drugs. 2020;80(12):1183–201. https://doi.org/10.1007/s40265-020-01349-1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Kay J, Harigai M, Rancourt J, et al. Changes in selected haematological parameters associated with JAK1/JAK2 inhibition observed in patients with rheumatoid arthritis treated with baricitinib. RMD Open. 2020;6(3):e001370. https://doi.org/10.1136/rmdopen-2020-001370.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Cohen SB, van Vollenhoven RF, Winthrop KL, et al. Safety profile of upadacitinib in rheumatoid arthritis: integrated analysis from the SELECT phase III clinical programme. Ann Rheum Dis. 2020:annrheumdis-2020-218510. https://doi.org/10.1136/annrheumdis-2020-218510.

  39. Europen Medicines Agency-Committee for Medicinal Products for Human Use (CHMP). Assessment report. Jyseleca (Filgotinib). 2020. https://www.ema.europa.eu/en/documents/assessment-report/jyseleca-epar-public-assessment-report_en.pdf. Accessed 24 Jan 2020.

  40. Alvaro-Gracia JM, Garcia-Llorente JF, Valderrama M, Gomez S, Montoro M. Update on the safety profile of tofacitinib in rheumatoid arthritis from clinical trials to real-world studies: a narrative review. Rheumatol Ther. 2020. https://doi.org/10.1007/s40744-020-00258-9.

  41. • Olivera PA, Lasa JS, Bonovas S, Danese S, Peyrin-Biroulet L. Safety of Janus kinase inhibitors in patients with inflammatory bowel diseases or other immune-mediated diseases: a systematic review and meta-analysis. Gastroenterology. 2020;158(6):1554–73 e12. https://doi.org/10.1053/j.gastro.2020.01.001A meta-analysis assesing the safety profile of JAK inhibitors in patients with with immune-mediated diseases including ankylosing spondylitis.

    Article  CAS  PubMed  Google Scholar 

  42. Wang F, Sun L, Wang S, et al. Efficacy and safety of tofacitinib, baricitinib, and upadacitinib for rheumatoid arthritis: a systematic review and meta-analysis. Mayo Clin Proc. 2020;95(7):1404–19. https://doi.org/10.1016/j.mayocp.2020.01.039.

    Article  CAS  PubMed  Google Scholar 

  43. • Pawar A, Desai RJ, Gautam N, Kim SC. Risk of admission to hospital for serious infection after initiating tofacitinib versus biologic DMARDs in patients with rheumatoid arthritis: a multidatabase cohort study. The Lancet Rheumatology. 2020;2(2):e84–98. https://doi.org/10.1016/s2665-9913(19)30137-7This is a multidatabase cohort study which compares the risk of admission to hospital for serious infection and individual seirous infection types including herpes zoster in patients with rheumatoid arthritis initiating tofacitinib versus one of the seven bDMARDs.

    Article  Google Scholar 

  44. Curtis JR, Xie F, Yun H, Bernatsky S, Winthrop KL. Real-world comparative risks of herpes virus infections in tofacitinib and biologic-treated patients with rheumatoid arthritis. Ann Rheum Dis. 2016;75(10):1843–7. https://doi.org/10.1136/annrheumdis-2016-209131.

    Article  CAS  PubMed  Google Scholar 

  45. Bechman K, Subesinghe S, Norton S, et al. A systematic review and meta-analysis of infection risk with small molecule JAK inhibitors in rheumatoid arthritis. Rheumatology (Oxford). 2019;58(10):1755–66. https://doi.org/10.1093/rheumatology/kez087.

    Article  CAS  PubMed  Google Scholar 

  46. • Cantini F, Blandizzi C, Niccoli L, Petrone L, Goletti D. Systematic review on tuberculosis risk in patients with rheumatoid arthritis receiving inhibitors of Janus Kinases. Expert Opin Drug Saf. 2020;19(7):861–72. https://doi.org/10.1080/14740338.2020.1774550A systematic review on the risk of active tuberculosis occurrence in patients receiving JAK inhibitors.

    Article  CAS  PubMed  Google Scholar 

  47. Scott IC, Hider SL, Scott DL. Thromboembolism with Janus kinase (JAK) inhibitors for rheumatoid arthritis: how real is the risk? Drug Saf. 2018;41(7):645–53. https://doi.org/10.1007/s40264-018-0651-5.

    Article  CAS  PubMed  Google Scholar 

  48. Ibrahim F, Scott DL. Thromboembolism and Janus kinase inhibitors. Drug Saf. 2020;43(9):831–3. https://doi.org/10.1007/s40264-020-00973-w.

    Article  PubMed  Google Scholar 

  49. FDA Drug Safety Communication. FDA approves Boxed Warning about increased risk of blood clots and death with higher dose of arthritis and ulcerative colitis medicine tofacitinib (Xeljanz, Xeljanz XR). US Food and Drug Administration. www.fda.gov/drugs/drug-safety-and-availability/fda-approves-boxed-warning-about-increased-risk-blood-clots-and-death-higher-dose-arthritis-and. Accessed 29 Dec 2020.

  50. Pfizer Inc. XELJANZ (Tofacitinib). EPAR-Product Information. European Medicines Agency. https://www.ema.europa.eu/en/documents/product-information/xeljanz-epar-product-information_en.pdf. Accessed 29 Dec 2020.

  51. Verden A, Dimbil M, Kyle R, Overstreet B, Hoffman KB. Analysis of spontaneous postmarket case reports submitted to the FDA regarding thromboembolic adverse events and JAK inhibitors. Drug Saf. 2018;41(4):357–61. https://doi.org/10.1007/s40264-017-0622-2.

    Article  CAS  PubMed  Google Scholar 

  52. Xie W, Huang Y, Xiao S, Sun X, Fan Y, Zhang Z. Impact of Janus kinase inhibitors on risk of cardiovascular events in patients with rheumatoid arthritis: systematic review and meta-analysis of randomised controlled trials. Ann Rheum Dis. 2019;78(8):1048–54. https://doi.org/10.1136/annrheumdis-2018-214846.

    Article  CAS  PubMed  Google Scholar 

  53. •• Yates M, Mootoo A, Adas M, et al. Venous thromboembolism risk with JAK inhibitors: a meta-analysis. Arthritis Rheumatol. 2020. https://doi.org/10.1002/art.41580.

  54. • Mease P, Charles-Schoeman C, Cohen S, et al. Incidence of venous and arterial thromboembolic events reported in the tofacitinib rheumatoid arthritis, psoriasis and psoriatic arthritis development programmes and from real-world data. Ann Rheum Dis. 2020;79(11):1400–13. https://doi.org/10.1136/annrheumdis-2019-216761A detailed analysis assesing the risk of deep vein thrombosis, pulmonary embolism, venous thromboembolism and arterial thromboembolism from the tofacitinib RA, PsA and PsO development programmes and observational studies.

    Article  CAS  PubMed  Google Scholar 

  55. •• Nash P, Kerschbaumer A, Dorner T, et al. Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: a consensus statement. Ann Rheum Dis. 2021;80(1):71–87. https://doi.org/10.1136/annrheumdis-2020-218398A useful consensus document providing an assessment of evidence for efficacy and safety of an JAKis with guidance on issues of practical management.

    Article  CAS  PubMed  Google Scholar 

  56. Vallejo-Yagüe E, Weiler S, Burden AM. Op0237 thromboembolic safety profile of tofacitinib and baricitinib: an analysis of who vigibase. Annals of the Rheumatic Diseases. 2020;79(Suppl 1):150.1. https://doi.org/10.1136/annrheumdis-2020-eular.2823.

    Article  Google Scholar 

  57. Wollenhaupt J, Lee EB, Curtis JR, et al. Safety and efficacy of tofacitinib for up to 9.5 years in the treatment of rheumatoid arthritis: final results of a global, open-label, long-term extension study. Arthritis Res Ther. 2019;21(1):89. https://doi.org/10.1186/s13075-019-1866-2.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Pfizer shares co-primary endpoint results from post-marketing required safety study of XELJANZ® (tofacitinib) in subjects with rheumatoid arthritis (RA). https://www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-co-primary-endpoint-results-post-marketing. Accessed 2 Mar 2021.

  59. Initial safety trial results find increased risk of serious heart-related problems and cancer with arthritis and ulcerative colitis medicine Xeljanz, Xeljanz XR (tofacitinib). https://www.fda.gov/drugs/drug-safety-and-availability/initial-safety-trial-results-find-increased-risk-serious-heart-related-problems-and-cancer-arthritis. Accessed 2 Mar 2021.

  60. Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol. 2019;71(10):1599–613. https://doi.org/10.1002/art.41042.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Pfizer Inc. XELJANZ® (tofacitinib) [package insert]. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213082s000lbl.pdf. Accessed 29 Dec 2020.

  62. Mease P, Hall S, FitzGerald O, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017;377(16):1537–50. https://doi.org/10.1056/NEJMoa1615975.

    Article  CAS  PubMed  Google Scholar 

  63. Gladman D, Rigby W, Azevedo VF, et al. Tofacitinib for psoriatic arthritis in patients with an inadequate response to TNF inhibitors. N Engl J Med. 2017;377(16):1525–36. https://doi.org/10.1056/NEJMoa1615977.

    Article  CAS  PubMed  Google Scholar 

  64. Mease PJ, Lertratanakul A, Anderson JK, et al. Upadacitinib for psoriatic arthritis refractory to biologics: SELECT-PsA 2. Ann Rheum Dis. 2020:annrheumdis-2020-218870. https://doi.org/10.1136/annrheumdis-2020-218870.

  65. Papp KA, Menter MA, Abe M, et al. Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials. Br J Dermatol. 2015;173(4):949–61. https://doi.org/10.1111/bjd.14018.

    Article  CAS  PubMed  Google Scholar 

  66. Panes J, Sandborn WJ, Schreiber S, et al. Tofacitinib for induction and maintenance therapy of Crohn's disease: results of two phase IIb randomised placebo-controlled trials. Gut. 2017;66(6):1049–59. https://doi.org/10.1136/gutjnl-2016-312735.

    Article  CAS  PubMed  Google Scholar 

  67. Rogler G. Efficacy of JAK inhibitors in Crohn’s disease. J Crohns Colitis. 2020;14(Supplement_2):S746–S54. https://doi.org/10.1093/ecco-jcc/jjz186.

    Article  PubMed  Google Scholar 

  68. Vermeire S, Schreiber S, Petryka R, et al. Clinical remission in patients with moderate-to-severe Crohn's disease treated with filgotinib (the FITZROY study): results from a phase 2, double-blind, randomised, placebo-controlled trial. Lancet. 2017;389(10066):266–75. https://doi.org/10.1016/S0140-6736(16)32537-5.

    Article  CAS  PubMed  Google Scholar 

  69. Miserocchi E, Giuffre C, Cornalba M, Pontikaki I, Cimaz R. JAK inhibitors in refractory juvenile idiopathic arthritis-associated uveitis. Clin Rheumatol. 2020;39(3):847–51. https://doi.org/10.1007/s10067-019-04875-w.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Figs. 1 and 2 were made using Biorender (BioRender.com).

Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Medicine, Manisa Celal Bayar University School of Medicine, Manisa, Turkey

    Nurullah Akkoc

  2. School of Medicine, Case Western Reserve University, 1722 Coes Post Run, Westlake, OH, 44145, USA

    Muhammad A. Khan

Authors
  1. Nurullah Akkoc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Muhammad A. Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nurullah Akkoc.

Ethics declarations

Conflict of Interest

Nurullah Akkoc: Consulting and/or speaking fees from UCB and speaking fees from Amgen. Muhammad A Khan: Receipt of consultation fees from AbbVie, Novartis, and Lilly and from speaker’s bureaus of AbbVie and Novartis.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Spondyloarthritis

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Akkoc, N., Khan, M.A. JAK Inhibitors for Axial Spondyloarthritis: What does the Future Hold?. Curr Rheumatol Rep 23, 34 (2021). https://doi.org/10.1007/s11926-021-01001-1

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11926-021-01001-1

Keywords

Search

Navigation