RHEUMATOID ARTHRITIS: Edited by Bryant R. EnglandRole of Janus Kinase inhibitors in rheumatoid arthritis treatmentReddy, Virginiaa,b; Cohen, Stanleya,c,dAuthor Information aRheumatology Department, THR Presbyterian Hospital bRheumatology Associates cUT Southwestern Medical School dMetroplex Clinical Research Center, Dallas, Texas, USA Correspondence to Stanley Cohen, MD, Medical Director, Metroplex Clinical Research Center, Dallas, TX 75231, USA. Tel: +1 214 707 1390; e-mail: [email protected] Current Opinion in Rheumatology: May 2021 - Volume 33 - Issue 3 - p 300-306 doi: 10.1097/BOR.0000000000000792 Buy Metrics Abstract Purpose of review To review recently published articles on use of Janus Kinase inhibitors (Jaki) in the clinic for rheumatoid arthritis (RA). Recent findings Several Jaki have been approved for RA patients failing csDMARDS. Over the last 2 years, EULAR and ACR have published updated recommendations for the pharmacologic management of RA providing guidance on the utilization of Jaki after csDMARD failure. Clinical trials have been published addressing the efficacy of Jaki monotherapy as patients often choose monotherapy because of a desire to avoid multiple therapies and aggravating adverse events with csDMARDs. Previous clinical trials have compared the efficacy and safety of Jaki to adalimumab, and a trial comparing abatacept to upadacitinib has recently been published. An increased risk of venous thromboembolism (VTE) has been suggested with Jaki and additional information has recently become available with conflicting results. Summary Jaki are now standard therapy for RA patients failing csDMARDs and are being utilized frequently as an alternative to biologics in patients without risk factors for VTE. Jaki monotherapy has been demonstrated to be effective, although combination therapy has been demonstrated to be superior in clinical and radiographic outcomes. Preliminary data suggests that cycling through Jaki in patients with incomplete response to initial Jaki treatment may be an appropriate strategy. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.