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JAK inhibitors !

Small oral molecules that block Janus kinases inside cells, cutting the signal of many cytokines at once. Used in arthritis, colitis and some marrow diseases.

Updated 2026-11-01

What they are

Tofacitinib and baricitinib are oral targeted DMARDs for rheumatoid arthritis and related diseases, usually after a TNF inhibitor has failed; ruxolitinib treats myelofibrosis, polycythaemia vera and graft-versus-host disease. Unlike biologics, they are tablets and act inside the cell.

Mechanism of action

Many cytokine receptors (IL-2, IL-6, interferons, GM-CSF, erythropoietin and others) have no kinase of their own and depend on associated Janus kinases (JAK1, JAK2, JAK3, TYK2). When the cytokine binds, the JAKs phosphorylate STAT proteins, which move to the nucleus and switch on inflammatory genes. JAK inhibitors compete with ATP in the kinase site and stop this step.

Target: Janus kinases (JAK1, JAK2, JAK3, TYK2)

Drugs in this class

Others in the class

  • upadacitinib
  • filgotinib

Test yourself

Think of the answer, then tap the question to see it.

Where do JAK inhibitors act, compared with biologic DMARDs?

Inside the cell, on the kinases attached to cytokine receptors; biologics act outside the cell on the cytokine or its receptor.

Which viral infection is especially common with JAK inhibitors?

Herpes zoster (shingles).

Which risks were higher with tofacitinib than with TNF inhibitors in rheumatoid arthritis?

All-cause mortality, major cardiovascular events, thrombosis, and lymphoma and lung cancer.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - TOFACITINIB tablet, film coated (DailyMed (U.S. National Library of Medicine), 2026); Baricitinib: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2022); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 39 (McGraw Hill, 2023).

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Representative model, for educational purposes only.