Inhibidores JAK en pacientes con artritis reumatoidea

Abstract

Background: Rheumatoid arthritis is a chronic, degenerative, and irreversible autoimmune disease. The World Health Organization reports that about eighteen million people suffer from this pathology, 70% of whom are women. Several drugs are used as therapy; however, many of them represent high costs, as well as several adverse effects. Nowadays, Janus Kinase (JAK) inhibitors are an effective alternative in certain patients since they have shown therapeutic benefits compared to conventional antirheumatic drugs and excellent therapeutic results in the inflammatory response. Objective: To compare the efficacy and safety of first-generation and second-generation JAK inhibitors in patients with rheumatoid arthritis. Methodology: A literature narrative review was conducted. Articles must meet the following inclusion criteria: original articles in Spanish and English published between 2016 and 2024, clinical trials, systematic reviews, and meta-analyses. Databases PubMed, Scopus, and Web of Science were used. Results: At the end of the selection phase, 24 articles were included. Nine clinical trials, nine meta-analyses, four systematic reviews, and two randomized controlled trials were analyzed. Conclusion: First and second-generation JAK inhibitors are effective in the treatment of rheumatoid arthritis, offering long-lasting therapeutic effects. Second-generation inhibitors show more rapid improvements in the American College of Rheumatology (ACR) 20, 50, and 70 response criteria compared to first-generation inhibitors. Although both types present risks, such as infections and increases in lipid levels, second-generation inhibitors appear to be safer. In addition, dosing may influence the incidence of severe adverse effects