The emerging role of Janus kinase inhibitors in the treatment of autoimmune and inflammatory diseases

Autoimmune and inflammatory diseases are common and diverse, and they can affect nearly any organ system. Much of the pathogenesis of these diseases is related to dysregulated cytokine activity. Historically, autoimmune and inflammatory diseases have been treated with medications that nonspecifically suppress the immune system. mAbs that block the action of pathogenic cytokines emerged 2 decades ago and have become widely useful. More recently, agents that simultaneously block multiple pathogenic cytokines via inhibition of the downstream Janus kinase (JAK)? signal transducer and activator of transcription pathway have emerged and are becoming increasingly important. These small molecule inhibitors, collectively termed JAK inhibitors, are US Food and Drug Administration?approved in a few autoimmune/ inflammatory disorders and are being evaluated in many others. Here, we review the biology of the JAK?signal transducer and activator of transcription pathway and the use of JAK inhibitors to treat autoimmune and inflammatory diseases across medical subspecialties. (J Allergy Clin Immunol 2021;147:814-26.)

Automated summary

Autoimmune and inflammatory diseases are commonly treated by targeting dysregulated cytokine activity, with the emergence of JAK inhibitors offering a new approach that simultaneously blocks multiple pathogenic cytokines. These small molecule inhibitors show promising results and are becoming increasingly important in the treatment of various autoimmune and inflammatory disorders.