Efficacy and safety of the Janus kinase inhibitor baricitinib in children with rheumatic diseases

The effectiveness of Janus kinase inhibitors in immunoinflammatory rheumatic, autoimmune non-rheumatic and autoinflammatory diseases is due to the involvement of cytokines in the pathogenesis of their development, the activation of which is mediated by the JAK-STAT signaling pathway in the cell nucleus. Its activation enhances the transcriptional response of genes associated with the development of autoimmune diseases and genes of proinflammatory cytokines. Janus kinase inhibitors such as tofacitinib, upadacitinib, ruxolitinib and baricitinib are currently available for pediatric patients with rheumatic and non-rheumatic diseases, but data on their efficacy and safety, as well as the list of indications for use are limited. In this literature review, we attempted to summarize the world experience of baricitinib use in children suffering from rheumatic diseases. Summarizing the results of previous studies, we can conclude that the use of baricitinib in children with juvenile arthritis is effective and safe, but further clinical trials in children with diffuse connective tissue diseases are needed. Key words: diffuse connective tissue diseases, systemic lupus erythematosus, baricitinib, juvenile idiopathic arthritis, Janus kinases