4.2 Review

Advances in pharmacotherapy for ulcerative colitis: a focus on JAK1 inhibitors

Journal

EXPERT OPINION ON PHARMACOTHERAPY
Volume 24, Issue 7, Pages 849-861

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14656566.2023.2200931

Keywords

Filgotinib; Upadacitinib; ivarmacitinib; JAK1; ulcerative colitis

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JAK inhibitors are emerging small-molecule drugs used for the treatment of ulcerative colitis and other immune mediated inflammatory diseases. They are orally bioavailable, have a rapid mechanism of action, and are non-immunogenic. Special attention should be given to elderly patients or those with cardiovascular or oncological risk factors, and JAK inhibitors should only be recommended when no alternatives are available. JAK inhibitors also have the potential to be combined with other drugs for the management of difficult-to-treat cases.
Introduction: Janus kinase (JAK) inhibitors are an emerging class of small-molecule drugs, providing targeted therapy for a variety of diseases, and have made their way into the treatment of armamentarium of ulcerative colitis (UC) in recent years.Areas covered: This review focuses on the pharmacokinetics, safety, and efficacy of selective JAK1 inhibitors in the treatment of moderate-to-severe UC. The PubMed database and clinicaltrials.gov were consulted using keywords - further expanded in the methods section. The search was focused on full-text publications in English. No publication date restrictions were imposed.Expert opinion: JAK1 inhibitors are small-molecule drugs used in the treatment of ulcerative colitis and other immune mediated inflammatory diseases. They are orally bioavailable and have a rapid mechanism of action and no immunogenicity. JAK inhibitors can be used for the management of both naive patients and biological-experienced patients.Particular attention should be paid to elderly patients or those with cardiovascular or oncological risk factors, in whom JAK inhibitors should be recommended only if no alternatives are available. In addition, JAK inhibitors have the potential to be combined with other biological drugs or small molecules for the management of difficult-to-treat cases.

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