Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?

Objective. Interstitial lung disease (ILD) is rare, but it is one of the most frequent extra-articular manifestations and a relevant cause of morbidity and mortality in rheumatoid arthritis (RA). Over the past few years, Janus kinase inhibitors (JAKis) have been reported to have promising efficacy...

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Main Authors: Beatrice Maranini, Roberta Foti, Moustapha Taha, Veronica Venturelli, Andrea Lo Monaco, Marcello Govoni
Format: Article
Language:English
Published: PAGEPress Publications 2025-01-01
Series:Reumatismo
Subjects:
Online Access:https://www.reumatismo.org/reuma/article/view/1754
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author Beatrice Maranini
Roberta Foti
Moustapha Taha
Veronica Venturelli
Andrea Lo Monaco
Marcello Govoni
author_facet Beatrice Maranini
Roberta Foti
Moustapha Taha
Veronica Venturelli
Andrea Lo Monaco
Marcello Govoni
author_sort Beatrice Maranini
collection DOAJ
description Objective. Interstitial lung disease (ILD) is rare, but it is one of the most frequent extra-articular manifestations and a relevant cause of morbidity and mortality in rheumatoid arthritis (RA). Over the past few years, Janus kinase inhibitors (JAKis) have been reported to have promising efficacy in the treatment of active RA, but recent concerns have been raised about their safety profile, namely malignancy and cardiovascular disease, limiting their use to certain patient categories. Methods. The objective of this narrative review is to summarize the current evidence of the efficacy and safety of JAKis in RA-ILD management, investigating a possible emerging role for this drug class in such subset of patients. Results. Current studies focusing on JAKis in RA-ILD are scarce, but they globally report an overall stabilization of respiratory symptoms, functional data, and radiographic extension of ILD. In some cohorts, JAKis determined even an encouraging improvement in lung disease, and few reports presented good tolerability of JAKis in combination with antifibrotics. Concerning the safety profile, no significant increased risk of pulmonary infection has been reported. Conclusions. Thus far, evidence regarding the role of JAKis in the treatment of RA-ILD remains relatively limited, and additional prospective studies are needed to better understand the place of JAKis, if any, in preventing/stabilizing ILD in RA patients.
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spelling doaj-art-b2eae4ea74154d61bde5bdf7d4faaea52025-01-30T02:32:19ZengPAGEPress PublicationsReumatismo0048-74492240-26832025-01-0110.4081/reumatismo.2025.1754Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?Beatrice Maranini0https://orcid.org/0000-0002-7313-3520Roberta Foti1https://orcid.org/0000-0002-3074-4508Moustapha Taha2https://orcid.org/0009-0000-3394-6298Veronica Venturelli3https://orcid.org/0000-0003-0681-1472Andrea Lo Monaco4https://orcid.org/0000-0002-1455-0818Marcello Govoni5https://orcid.org/0000-0003-0499-5773Rheumatology Unit, Department of Medical Sciences, University of FerraraRheumatology Unit, Department of Medical Sciences, University of FerraraRheumatology Unit, Department of Medical Sciences, University of FerraraRheumatology Unit, Department of Medical Sciences, University of FerraraRheumatology Unit, Department of Medical Sciences, University of FerraraRheumatology Unit, Department of Medical Sciences, University of Ferrara Objective. Interstitial lung disease (ILD) is rare, but it is one of the most frequent extra-articular manifestations and a relevant cause of morbidity and mortality in rheumatoid arthritis (RA). Over the past few years, Janus kinase inhibitors (JAKis) have been reported to have promising efficacy in the treatment of active RA, but recent concerns have been raised about their safety profile, namely malignancy and cardiovascular disease, limiting their use to certain patient categories. Methods. The objective of this narrative review is to summarize the current evidence of the efficacy and safety of JAKis in RA-ILD management, investigating a possible emerging role for this drug class in such subset of patients. Results. Current studies focusing on JAKis in RA-ILD are scarce, but they globally report an overall stabilization of respiratory symptoms, functional data, and radiographic extension of ILD. In some cohorts, JAKis determined even an encouraging improvement in lung disease, and few reports presented good tolerability of JAKis in combination with antifibrotics. Concerning the safety profile, no significant increased risk of pulmonary infection has been reported. Conclusions. Thus far, evidence regarding the role of JAKis in the treatment of RA-ILD remains relatively limited, and additional prospective studies are needed to better understand the place of JAKis, if any, in preventing/stabilizing ILD in RA patients. https://www.reumatismo.org/reuma/article/view/1754JAK inhibitorsinterstitial lung diseaseILDrheumatoid arthritisRA
spellingShingle Beatrice Maranini
Roberta Foti
Moustapha Taha
Veronica Venturelli
Andrea Lo Monaco
Marcello Govoni
Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?
Reumatismo
JAK inhibitors
interstitial lung disease
ILD
rheumatoid arthritis
RA
title Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?
title_full Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?
title_fullStr Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?
title_full_unstemmed Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?
title_short Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?
title_sort janus kinase inhibitors in rheumatoid arthritis associated interstitial lung disease where do we stand and what may be the future
topic JAK inhibitors
interstitial lung disease
ILD
rheumatoid arthritis
RA
url https://www.reumatismo.org/reuma/article/view/1754
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