About Janus Kinase Inhibitors:
Janus kinase (JAK) inhibitors are also called jakinibs.
The Janus kinase family consists of four receptor-associated tyrosine kinases – JAK1, JAK2, JAK3 and tyrosine kinase 2 (TYK2). When activated, JAKs phosphorylate cell membrane cytokine receptors and intracytoplasmic STATs, thereby modulating gene transcription in the nucleus. The phosphate is provided by ATP, and each JAK and tyrosine kinase recognizes a slightly different ATP-binding pocket. Overexpression of these pathways results in the development of autoimmune disease and malignancies.
Uses of Janus Kinase Inhibitors:
• Atopic dermatitis :
Topical - Delgocitinib, Ruxolitinib, Tofacitinib,
Oral - Tofacitinib, Baricitinib, Abrocitinib,
• Plaque psoriasis :
Topical — ruxolitinib, brepocitinib
Oral — tofacitinib, baricitinib, peficitinib, deucravacitinib, filotinib, delgocitinib, itacitinib
Oral tofacitinib for nail psoriasis
• Alopecia areata :
Oral - Tofacitinib, Ruxolitinib, Baricitinib
• Vitiligo :
Topical - ruxolitinib, tofacitinib
Oral - tofacitinib
• Other dermatoses :
• Chronic hand dermatitis :
Topical - delgocitinib
• Dermatomyositis :
Oral - ruxolitinib, tofacitinib
• Graft versus host disease (GVHD) :
Oral - ruxolitinib, baricitinib, itacitinib — as prophylaxis or treatment of acute or chronic GVHD
• Lichen planus/lichen planopilaris :
Topical - ruxolitinib,
Oral - tofacitinib
• Systemic lupus erythematosus/discoid lupus erythematosus : Oral - baricitinib, elsubrutinib, upadacitinib
• Granulomatous disorders including sarcoidosis, granuloma annulare, necrobiosis lipoidica :
Oral tofacitinib,
What are the contraindications with Janus kinase inhibitors?
severe liver damage.
pregnancy and lactation.
Hypersensitivity to the drug or any excipient of the product.
Concurrent biological agents or other potent immunosuppressant agents.
Types of JAK inhibitors (JAKi):
Pan-Zaki - dalgocitinib, peficitinib
JAK1i - oclacitinib, upadacitinib, abrocitinib, itacitinib
JAK1/2i - baricitinib, ruxolitinib
JAK1/3i — tofacitinib
JAK3i - decernotinib, ritlecitinib
TYK2 inhibitors - daucravacitinib, brepocitinib.
Common adverse side effects of JAK inhibitors:
nasopharyngitis,
upper respiratory and urinary tract infections,
Headache,
nausea,
Diarrhea,