JAK INHIBITORS IN THE TREATMENT OF RHEUMATOID ARTHRITIS: EFFICACY, SAFETY AND CURRENT PERSPECTIVES

• DOI: https://doi.org/10.22533/at.ed.1595172511041

• Palavras-chave: Rheumatoid arthritis; JAK inhibitors; Chronic inflammation; Extra-articular manifestations; Therapeutic safety

• Keywords: Rheumatoid arthritis; JAK inhibitors; Chronic inflammation; Extra-articular manifestations; Therapeutic safety

• Abstract:

  Objective: To analyze the role of JAK inhibitors in the treatment of rheumatoid arthritis, assessing their efficacy, safety and impact on patients' quality of life. Methodology: Bibliographic review conducted according to the PVO strategy. Articles were searched in the PubMed-MEDLINE database using descriptors related to rheumatoid arthritis and JAK inhibitors. After applying inclusion and exclusion criteria, 28 articles were selected for analysis. Discussion: RA is a chronic immune-mediated inflammatory disease which, in addition to joint involvement, can cause extra-articular manifestations such as pericarditis, vasculitis and pleural effusion, impacting on the patient's quality of life. With an incidence of approximately 1% of the population, RA is more prevalent in women and its frequency increases with age. The development of JAK inhibitors, such as tofacitinib, baricitinib, upadacitinib and filgotinib, represented a breakthrough in treatment, reducing inflammatory activity and preserving joint function. However, the safety profile of these molecules varies according to their selectivity for JAK isoforms. While more selective drugs, such as upadacitinib and filgotinib, reduce the impact on hematopoietic pathways, others, such as tofacitinib and baricitinib, inhibit multiple isoforms, increasing the risk of opportunistic infections, cardiovascular events and potentially increasing the risk of malignancy. Final considerations: JAK inhibitors are an effective therapeutic alternative for RA, comparable to biological DMARDs and with convenient oral administration. However, long-term safety requires close monitoring. Future research is essential to refine patient selection and optimize therapeutic strategies, ensuring a balance between clinical benefits and potential risks.