Ever heard of janus kinase? Well, according to researchers this inhibitor has proven to be a new option for treating rheumatoid arthritis.
In a large-scale, international study led by renowned rheumatologist Josef Smolen from the Department of Medicine III, a still-to-be-approved drug containing the selective janus kinase inhibitor upadacitinib has proved itself to be a new option for treating rheumatoid arthritis (RA).
It was discovered that between 12.5% and 20% of patients who were given the drug on a daily basis experienced so-called sustained remission, which is a state that is almost like being cured.
Janus kinases and treating rheumatoid arthritis
Published in The Lancet, janus kinases (JAK) plays an important role in intracellular signal transmission and are necessary to forward signals from various receptors to the cell nucleus. In rheumatism, however, they are responsible for inflammatory responses. These are curbed by JK inhibitors.
There are already two other JAK inhibitors (tofacitinib and baricitinib), which are also used for treating rheumatoid arthritis – but mostly as combination therapy with the standard therapy methotrexate.
However, in the current study involving more than 600 patients, the researchers were able to show that a significant improvement can be achieved with upadacitinib as monotherapy: “With a daily dose of 15 mg, more than one third of patients achieved low disease activity, and, at 30 mg, the proportion was nearly 50%,” says Josef Smolen the MedUni Vienna researcher, summarising the results.
“12.5% of the group on the low dose and around 20% on the higher dose achieved so-called sustained remission, that is to say complete disappearance of disease activity. And that was after only three months.”
Tablet over injection
This treatment option is vital as rheumatoid arthritis patients are initially treated with the standard antirheumatic agent methotrexate for six months, and indeed many of them respond very well to this. However, if they do not respond and no remission or at least reduction in disease activity can be achieved, they are given a combined treatment of methotrexate and a biologic agent – frequently anti-TNF, such as adalimumab, administered by injection, which involves risk factors.
Whereas, treatment with janus kinase inhibitors has already been described by rheumatism experts at MedUni Vienna as being equally good and it has the advantage that it does not involve an injection but is given in the form of a daily tablet, making it a simpler form of treatment.
“It works extremely quickly – a good response is noticeable after only two to four weeks.” concludes Smolen.