JAK Inhibitors Might be The Future of Autoimmune Disease Treatment, Including RA

In a previous blog post, we promised to give you more info about the treatments for rheumatoid arthritis that are currently in use, as well as other options such as clinical trials that show up in FindMeCure’s database. As we already mentioned, even though there is no “cure” for RA, the disease is shown to go into remission more often than not when it’s diagnosed early, and treatment begins right away.

Available treatments for RA

But what are the available treatments, apart from investigational drugs? The drugs currently used to influence the development of RA, to slow down the process and prevent the joints and other tissues from permanent damage, are known as DMARDs – disease-modifying antirheumatic drugs, which include methotrexate and leflunomide. Although highly effective, these drugs can cause liver damage or lung infections in the most serious cases. There is a newer class of DMARDs, biologic agents or biologic response modifiers, which target the parts of the immune system responsible for the inflammation, but they can increase the risk of infections. Of course, there are no drugs that are completely risk-free, but we still look to the future with hopes of a cure with minimum side-effects.

Besides DMARDs, your physician may send you to physical therapy in order for you to keep your joints as active as possible or learn some ways to cope with your condition, including how to do day-to-day tasks without putting unnecessary stress on your joints and how to use assistive devices. And if neither the drugs nor the therapy helps much, in cases of severe RA symptoms there is surgery, which includes synovectomy (removal of the inflamed lining of the joint) and total joint replacement.

None of the treatments currently in use sound ideal, but this is what we have for now. Well, at least until the investigational new drugs enter phase IV (which means they have been approved by the FDA for use in the general population). Which brings us to our next option – clinical trials. A quick search on the FindMeCure’s website comes up with 370 clinical trials for RA around the world, testing different drugs, therapies, and devices. So we decided to limit our search and get you familiar with the most promising drugs in development, stage III – just one step away from being approved for marketing by the FDA.

JAK inhibitors are the future?

Judging by the results our search came up with (every other clinical trial in the UK or US is on it) and by all the hype online[1] the future of autoimmune disease medications (and RA is essentially an autoimmune disease) might be JAK inhibitors. Wait, what? Okay, I’m not too familiar with what goes on in our bodies on a cellular level, but basically, Janus Kinase Inhibitors work by blocking cytokine signaling, and cytokines are a group of proteins which play a huge role in the immune response.

Filgotinib, a kind of a JAK inhibitor, is currently in clinical trials in the UK and US, and many other locations including Argentina, Australia, Canada, Germany, India, Japan, New Zealand and so on. One is a comparative study, looking into the effects of  filgotinib in combination with methotrexate (a DMARD), while another clinical trial is studying the effects of filgotinib compared to placebo in adults with RA who “have an inadequate response to biologic disease-modifying anti-rheumatic drug(s) (DMARDs) treatment”.

Another JAK inhibitor, ABT-494 or updacitinib, is also in clinical trials in the UK, US and many other countries, but it’s not recruiting right now, even though it is ongoing and therefore the drug is still being investigated. If you, however, are interested in the drug, there is another trial, currently recruiting, which is studying the effect of ABT-494 on patients with moderate to severe RA, who are limited from taking biological DMARDs due to being intolerant to them.

Another study on the immunomodulator olokizumab is also recruiting and the drug has shown to be promising against placebo in a phase II trial.

There are, of course, studies on another therapies and devices, there is even a study on the “Effects of Social Networking on Chronic Disease Management in Arthritis”. The clinical trial landscape for RA, however, is dominated by JAK inhibitors, which makes us think that’s the direction RA treatment is going to develop in, in the years to come.

Find more treatments in development with FindMeCure!

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778139/

Article by Nelly Katsarova