PMID- 36913180
OWN - NLM
STAT- MEDLINE
DCOM- 20230321
LR  - 20230603
IS  - 1179-1950 (Electronic)
IS  - 0012-6667 (Print)
IS  - 0012-6667 (Linking)
VI  - 83
IP  - 4
DP  - 2023 Mar
TI  - Safety of Janus Kinase Inhibitors in Inflammatory Bowel Diseases.
PG  - 299-314
LID - 10.1007/s40265-023-01840-5 [doi]
AB  - In recent years, better knowledge of the pathophysiology of inflammatory bowel 
      diseases (IBD) has led to a relevant expansion of the therapeutic arsenal for 
      these conditions. Janus kinase (JAK) inhibitors are a family of small molecules 
      that block one or more of the intracellular tyrosine kinases, including JAK-1, 
      JAK-2, JAK-3 and TYK-2. Tofacitinib, a non-selective small molecule JAK 
      inhibitor, and upadacitinib and filgotinib, which are selective JAK-1 inhibitors, 
      have been approved by the US Food and Drug Administration (FDA) for 
      moderate-to-severe active ulcerative colitis. Compared to biological drugs, JAK 
      inhibitors have a short half-life, rapid onset of action, and no immunogenicity. 
      Both clinical trials and real-world evidence support the use of JAK inhibitors in 
      the treatment of IBD. However, these therapies have been linked with multiple 
      adverse events (AEs) including infection, hypercholesterolemia, venous 
      thromboembolism, major adverse cardiovascular events, and malignancy. While early 
      studies recognized several potential AEs, post-marketing trials have shown that 
      tofacitinib may increase the risk of thromboembolic diseases and major 
      cardiovascular events. The latter are seen in patients aged 50 years or older 
      with cardiovascular risk factors. Hence, the benefits of treatment and risk 
      stratification need to be considered when positioning tofacitinib. Novel JAK 
      inhibitors with a more selective effect on JAK-1 have proven to be effective in 
      both Crohn's disease and ulcerative colitis, offering a potentially safer and 
      efficacious therapeutic option to patients, including those with previous 
      non-response to other therapies such as biologics. Nevertheless, long-term 
      effectiveness and safety data are required.
CI  - (c) 2023. The Author(s).
FAU - Nunez, Paulina
AU  - Nunez P
AUID- ORCID: 0000-0003-3727-1851
AD  - Department of Gastroenterology, Hospital San Juan De Dios-Universidad de los 
      Andes, Digestive Disease Center, Clinica Universidad de los Andes, Universidad de 
      Chile Santiago, 7620157, Santiago, Chile.
FAU - Quera, Rodrigo
AU  - Quera R
AUID- ORCID: 0000-0001-5854-0526
AD  - Universidad de los Andes, Digestive Disease Center, Clinica Universidad de los 
      Andes, 7620157, Santiago, Chile.
FAU - Yarur, Andres J
AU  - Yarur AJ
AUID- ORCID: 0000-0003-2293-5555
AD  - Cedars-Sinai Medical Center, 8730 Alden Dr.Thalians 2E, Los Angeles, CA, 90048, 
      USA. andres.yarur@cshs.org.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230313
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Janus Kinase Inhibitors)
RN  - EC 2.7.10.2 (Janus Kinases)
SB  - IM
MH  - Humans
MH  - *Janus Kinase Inhibitors/adverse effects
MH  - *Colitis, Ulcerative/drug therapy
MH  - *Inflammatory Bowel Diseases/drug therapy
MH  - *Crohn Disease/drug therapy
MH  - *Cardiovascular Diseases/drug therapy
MH  - Janus Kinases
PMC - PMC10010235
COIS- PN has been a consultant for Janssen and Ferring, RQ has been a consultant for 
      Jansen and AJY has been a consultant for Takeda, Pfizer, Bristol Myers Squibb, 
      Arena pharmaceuticals, Prometheus Labs and Procise.
EDAT- 2023/03/14 06:00
MHDA- 2023/03/22 06:00
PMCR- 2023/03/13
CRDT- 2023/03/13 12:28
PHST- 2023/01/29 00:00 [accepted]
PHST- 2023/03/14 06:00 [pubmed]
PHST- 2023/03/22 06:00 [medline]
PHST- 2023/03/13 12:28 [entrez]
PHST- 2023/03/13 00:00 [pmc-release]
AID - 10.1007/s40265-023-01840-5 [pii]
AID - 1840 [pii]
AID - 10.1007/s40265-023-01840-5 [doi]
PST - ppublish
SO  - Drugs. 2023 Mar;83(4):299-314. doi: 10.1007/s40265-023-01840-5. Epub 2023 Mar 13.