New Insights on Janus Kinase Inhibitors (JAKi) in Immune-Mediated Inflammatory Diseases
Two comprehensive systematic reviews published in Annals of the Rheumatic Diseases
The treatment landscape of immune-mediated inflammatory diseases (IMIDs) has evolved significantly with the advent of Janus kinase inhibitors (JAKi). To provide a clearer and evidence-based perspective on the efficacy and safety of these agents, two extensive systematic literature reviews first-authored by Victoria Konzett, a junior rheumatologist from our division, have been published in the Annals of the Rheumatic Diseases (2025). These reviews formed the scientific backbone for the 2024 update of the international expert consensus statement on the use of JAK inhibitors in IMIDs.
Efficacy of JAK Inhibitors in IMIDs
In the first review, Efficacy of JAK Inhibitors in Immune-Mediated Inflammatory Diseases, Victoria and her co-authors systematically screened over 10,500 records. The review encompasses the evaluation of 21 different JAK inhibitors across 51 IMIDs, analyzing data from 102 randomized controlled trials. The findings provide a broad overview of the effectiveness of JAKi therapies in a wide range of diseases, including rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, and others.
Importantly, the review also explores the evolving concept of JAK selectivity, providing a framework for understanding how differential inhibition of JAK subtypes might influence both efficacy and safety. These insights are critical as the field moves toward more tailored and mechanism-driven treatment strategies.
Safety of JAK Inhibitors in IMIDs
The second review, Safety of JAK Inhibitors in Immune-Mediated Inflammatory Diseases, offers a comprehensive safety profile based on the screening of more than 13,900 records. Drawing from 209 studies, including clinical trials, long-term extension studies, and real-world evidence, the review addresses key safety concerns such as:
- Cardiovascular events
- Serious infections
- Malignancy risks
This thorough analysis supports informed risk-benefit assessments, essential for personalized care. The review emphasizes the importance of patient stratification and vigilance in monitoring, especially in populations at increased risk for adverse events.
Advancing Evidence-Based Practice
Together, these reviews deliver critical updates for clinicians, researchers, and policymakers working to optimize the use of JAK inhibitors in immune-mediated diseases. They underscore the importance of balancing efficacy with safety and highlight the continued need for individualized treatment strategies that reflect the heterogeneity of IMIDs and their patient populations.
Acknowledgements
These landmark studies were spearheaded by Victoria Konzett, PhD candidate at the Division of Rheumatology, Medical University of Vienna, who served as first and corresponding author on both publications. We extend our congratulations to Victoria and all co-authors for their outstanding contributions.
Read the full articles in the Annals of the Rheumatic Diseases (2025 edition):
https://doi.org/10.1016/j.ard.2025.01.024
https://doi.org/10.1016/j.ard.2025.01.023
For more information about our ongoing research at the Division of Rheumatology, explore our research page.